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Ran J, Dai Z, Wang S, Li L, Zheng Y, Qu G, Liu C, Chen M. Cancer screening and prevention education in standardized training residents: A cross-sectional survey in single center. BMC MEDICAL EDUCATION 2022; 22:827. [PMID: 36457021 PMCID: PMC9714006 DOI: 10.1186/s12909-022-03876-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/08/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Standardized residency training is an essential aspect of enhancing the ability of cancer prevention and screening of residents. The current study was performed to investigate tumor prevention, screening literacy and the training demands of standardized training residents and explore related influencing factors. METHODS A cross-sectional survey was conducted among 320 residents of The First Hospital of Lanzhou University. An online, self-designed questionnaire was employed to investigate tumor prevention and screening, training status, and the requirements of residents. Data were analyzed using Fisher's exact test. RESULTS The mean age of the 320 participants was 26.04 ± 1.85 years;133, 83, and 104 were in the 1st, 2nd and 3rd year of standardized training, respectively. Among the common carcinogenic factors, smoking, infectious agents, and drinking were more correlated with tumors by 72.19, 66.57, and 64.38% of the physicians, respectively. Excess body weight, an insufficient intake of fruits and dietary fiber, and a lack of exercise were correlated with tumors by only 26.56, 25, and 23.44% of the physicians, respectively. The proportion of physicians providing an accurate answer to the tumor screening question ranged from 23.13 to 93.13%. The lowest accuracy was 23.13% for the initial age of regular breast cancer screening in general-risk women. The maximum rate of the primary liver cancer screening methods was 93.13%. Postgraduates and residents of oncology practitioners considered excess body weight and the insufficient intake of fruits and dietary fiber more relevant to cancer (P < 0.05). Male residents viewed more associations between tumors and a lack of exercise and air pollution (P < 0.05). Overall, 71.26% of participants felt that their tumor prevention and screening knowledge was poor and 95.31% thought they needed standardized tumor prevention and screening training. CONCLUSION Tumor prevention and screening literacy of standardized training residents should be further improved. There is a huge knowledge demand for tumor prevention and screening. Therefore, it is vital to build a training program in line with the requirements of cancer prevention and control efforts that focus on improving literacy among residents.
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Affiliation(s)
- Juntao Ran
- Department of Radiation Oncology, the First Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China.
| | - Ziying Dai
- Department of Radiation Oncology, the First Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Song Wang
- Department of Radiation Oncology, the First Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Li Li
- Office of Standardized Training for Physicians, The first Hospital of Lanzhou University, Lanzhou, China
| | - Ya Zheng
- Department of Gastroenterology, The first Hospital of Lanzhou University, Lanzhou, China
| | - Guofeng Qu
- Department of Radiation Oncology, the First Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Chun Liu
- Department of Nuclear Medicine, The first Hospital of Lanzhou University, Lanzhou, China
| | - Ming Chen
- Department of Nuclear Medicine, The first Hospital of Lanzhou University, Lanzhou, China
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Wang D, Wu J, Du J, Ong H, Tang B, Dozier M, Weller D, Campbell C. Acceptability of and barriers to human papillomavirus vaccination in China: A systematic review of the Chinese and English scientific literature. Eur J Cancer Care (Engl) 2022; 31:e13566. [PMID: 35229931 PMCID: PMC9287030 DOI: 10.1111/ecc.13566] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Widespread adoption of the human papillomavirus (HPV) vaccine will require population acceptance and tailoring of immunisation services to community needs and preferences. We examined peer-reviewed publications on the acceptability of and barriers to the HPV vaccine across China. METHODS We searched English (MEDLINE, Embase, and Web of Science) and Chinese (CNKI, VIP, Wanfang data) databases between 1 January 2006 and 31 December 2017. We adopted a narrative approach for data synthesis. RESULTS We identified 73 studies. The overall median acceptability of HPV vaccine was 71.8% (Q1-Q3: 58.6%-81%). Low levels of acceptability (<40%) of HPV vaccine were found in eastern regions of China. The largest differences of acceptability were observed between rural western regions (all >90%) and urban eastern regions (all <35%). Despite these regional variations, common barriers to HPV vaccine acceptance were concerns about vaccine safety, uncertainty over vaccine effectiveness, low perceived risk of cervical cancer and the price of the vaccine. The level of willingness to pay for the HPV vaccine (over 153 US dollars) was very low (<7%). CONCLUSION The acceptability of and attitudes towards HPV vaccine vary by regions and populations across China. HPV vaccination programmes will need to tailor service delivery as well as information materials to take account of regional concerns.
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Affiliation(s)
- Du Wang
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK.,The George Institute for Global Health, Peking University Health Science Center, Beijing, China
| | - Jing Wu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Haley Ong
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK
| | - Biwei Tang
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Marshall Dozier
- College Lead for Library Academic Support, Medicine & Veterinary Medicine Library & University, University of Edinburgh, Edinburgh, UK
| | - David Weller
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK
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Luo D, Peng M, Wei X, Pan D, Xue H, Xu Y, Dong B. Prevalence of Human Papillomavirus and Genotype Distribution in Pregnant and Non-Pregnant Women in China. Risk Manag Healthc Policy 2021; 14:3147-3157. [PMID: 34349575 PMCID: PMC8326939 DOI: 10.2147/rmhp.s288838] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 06/09/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The status of human papillomavirus (HPV) infection in pregnant and non-pregnant women in China remains unclear. This study aimed to compare the prevalence and genotype distributions of HPV between pregnant and non-pregnant women in China. Patients and Methods A case-control study was conducted of pregnant women during the second trimester and age-matched non-pregnant women attending the Fujian Maternity and Child Health Hospital between January 1, 2017 and December 31, 2018. Participants underwent cervical cytology testing and HPV genotyping. The genotyping test was able to identify 14 high-risk HPV (HR-HPV), four possible HR-HPV, and five low-risk HPV (LR-HPV) types. Further colposcopy and a cervical biopsy were performed if indicated. The primary outcomes were HPV prevalence and genotype distribution. Results In total, 1077 pregnant and 1077 non-pregnant women were enrolled. Compared with non-pregnant women, pregnant women had a higher prevalence of HPV (24.2% vs 14.8%), HR-HPV (20.2% vs 11.7%), and LR-HPV (8% vs 4.5%) infection. In pregnant women, the most prevalent HPV genotypes were HPV-52 (6.0%), -16 (3.5%), -58 (2.6%), -53 (2.5%), and -51 (2.5%), while in non-pregnant women the most prevalent genotypes were HPV-52 (3.6%), -81 (1.9%), -51 (1.8%), -68 (1.4%), and -16 (1.3%). In women aged ≥35 years, HR-HPV (P=0.002) and LR-HPV (P=0.001) prevalence were significantly higher in pregnant women. However, in women aged <35 years, only HR-HPV prevalence was higher in pregnant women. Pregnant and non-pregnant women with HPV-16 and HPV-58 infection had a high prevalence of high-grade squamous intra-epithelial lesions (HSIL) (HPV-16: P<0.001 and P=0.005, HPV-58: P=0.043 and P=0.005); but with other HR-HPV genotypes, only non-pregnant women had an increased HSIL prevalence. Conclusion In China, the HPV prevalence is higher in pregnant women than that in non-pregnant women and is also age- and genotype-dependent. HPV-infected pregnant women aged ≥35 years and those with HPV-16 should be closely monitored to enable rapid clinical intervention.
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Affiliation(s)
- Dandan Luo
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Meilian Peng
- Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Xizhen Wei
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Diling Pan
- Department of Pathology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Huifeng Xue
- Fujian Provincial Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Yuying Xu
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Binhua Dong
- Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
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Kirubarajan A, Leung S, Li X, Yau M, Sobel M. Barriers and facilitators for cervical cancer screening among adolescents and young people: a systematic review. BMC Womens Health 2021; 21:122. [PMID: 33757512 PMCID: PMC7989022 DOI: 10.1186/s12905-021-01264-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 03/14/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Though cervical cancer is one of the leading causes of cancer-related death globally, its incidence is nearly entirely preventable. Young people have been an international priority for screening as this population has historically been under-screened. However, in both high-income and low-income countries, young people have not been screened appropriately according to country-specific guidelines. The aim of this systematic review was to systematically characterize the existing literature on barriers and facilitators for cervical cancer screening (CCS) among adolescents and young people globally. METHODS We conducted a systematic review following PRISMA guidelines of three key databases: Medline-OVID, EMBASE, and CINAHL. Supplementary searches were done through ClinicialTrials.Gov and Scopus. Databases were examined from 1946 until the date of our literature searches on March 12th 2020. We only examined original, peer-reviewed literature. Articles were excluded if they did not specifically discuss CCS, were not specific to individuals under the age of 35, or did not report outcomes or evaluation. All screening, extraction, and synthesis was completed in duplicate with two independent reviewers. Outcomes were summarized descriptively. Risk of bias for individual studies was graded using an adapted rating scale based on the Risk of Bias Instrument for Cross-Sectional Surveys of Attitudes and Practices. RESULTS Of the 2177 original database citations, we included 36 studies that met inclusion criteria. The 36 studies included a total of 14,362 participants, and around half (17/36, 47.2%) of studies specifically targeted students. The majority of studies (31/36, 86.1%) discussed barriers and facilitators to Pap testing specifically, while one study analyzed self-sampling (1/36, 2.8%), one study targeted HPV DNA testing (1/36, 2.8%), and the remainder (4/36, 11.1%) were not specified. Our systematic review found that there are three large categories of barriers for young people: lack of knowledge/awareness, negative perceptions of the test, and systemic barriers to testing. Facilitators included stronger relationships with healthcare providers, social norms, support from family, and self-efficacy. CONCLUSION There are unique barriers and facilitators that affect CCS rates in adolescents and young people. Health systems and healthcare providers worldwide should address the challenges for this unique population.
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Affiliation(s)
- Abirami Kirubarajan
- Faculty of Medicine, University of Toronto, 1 Kings College Circle, Medical Science Building, Toronto, ON, M5S 1A8, Canada.
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
| | - Shannon Leung
- Faculty of Medicine, University of Toronto, 1 Kings College Circle, Medical Science Building, Toronto, ON, M5S 1A8, Canada
| | - Xinglin Li
- Faculty of Medicine, University of Toronto, 1 Kings College Circle, Medical Science Building, Toronto, ON, M5S 1A8, Canada
| | - Matthew Yau
- Faculty of Medicine, University of Toronto, 1 Kings College Circle, Medical Science Building, Toronto, ON, M5S 1A8, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Mara Sobel
- Department of Obstetrics and Gynecology, Sinai Health System, Toronto, ON, Canada
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Ou L, Chen ACC, Reifsnider E. Review of Chinese young adults' human papillomavirus knowledge, attitudes, and vaccine acceptability. Public Health Nurs 2021; 38:701-714. [PMID: 33715199 DOI: 10.1111/phn.12893] [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: 11/22/2020] [Revised: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The human papillomavirus (HPV) vaccine is effective in reducing HPV-related disease. The 2-, 4-, and 9-valent HPV vaccines have been approved by the Chinese FDA since 2016; however, factors associated with HPV vaccine acceptability and use in Chinese young adults remain unclear. DESIGN AND SAMPLE We conducted a systematic review to analyze factors affecting HPV vaccine acceptability and use in Chinese young adults. A comprehensive search of databases (e.g., PubMed, CINAHL, and PsycINFO) was conducted, and articles between 2011 and 2020 were included. RESULTS Seventeen studies were included in the final review, and eleven were conducted in mainland China and six in Hong Kong. All studies reported low level of HPV-related knowledge. Better knowledge, more concerns about HPV-associated diseases, and being female were found associated with higher vaccine acceptability. The vaccine cost and safety were the major concerns for vaccination. CONCLUSIONS Findings suggested a low level of HPV-related knowledge and suboptimal vaccination rate in Chinese young adults. Theory-based interventions addressing knowledge and other influencing factors and involving both males and females are urgently needed to increase vaccine acceptability and use in Chinese young adults.
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Affiliation(s)
- Lihong Ou
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Angela Chia-Chen Chen
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Elizabeth Reifsnider
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
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Li M, Zhao Y, Qie M, Zhang Y, Li L, Lin B, Guo R, You Z, An R, Liu J, Zhang Z, Bi H, Hong Y, Chang S, He G, Hua K, Zhou Q, Liao Q, Wang Y, Wang J, Li X, Wei L. Management of Cervical Cancer in Pregnant Women: A Multi-Center Retrospective Study in China. Front Med (Lausanne) 2020; 7:538815. [PMID: 33365317 PMCID: PMC7750630 DOI: 10.3389/fmed.2020.538815] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 11/13/2020] [Indexed: 11/13/2022] Open
Abstract
Background: This retrospective multi-center study aimed to describe the epidemiological characteristics, clinical features, and management of patients with cervical cancer in pregnancy (CCIP) and evaluate maternal and infant outcomes. Methods: The data of patients with CCIP were retrospectively collected from those diagnosed and treated in 17 hospitals in 12 provinces in China between January 2009 and November 2017. The information retrieved included patients' age, clinical features of the tumor, medical management (during pregnancy or postpartum), obstetrical indicators (i.e., gestational age at diagnosis, delivery mode, and birth weight), and maternal and neonatal outcomes. Survival analyses were performed using Kaplan-Meier survival curves and log-rank tests that estimated the overall survival of patients. Results: One-hundred and five women diagnosed with CCIP (median age = 35 years) were identified from ~45,600 cervical cancer patients (0.23%) and 525,000 pregnant women (0.020%). The median gestational age at cancer diagnosis was 20.0 weeks. The clinical-stage of 93.3% of the patients with CCIP was IB1, 81.9% visited the clinic because of vaginal bleeding during pregnancy, and 72.4% had not been screened for cervical cancer in more than 5 years. To analyze cancer treatments during pregnancy, patients were grouped into two groups, termination of pregnancy (TOP, n = 67) and continuation of pregnancy (COP, n = 38). Analyses suggested that the TOP group was more likely to be diagnosed at an earlier gestational stage than the COP group (14.8 vs. 30.8 weeks, p < 0.001). The unadjusted hazard ratio for the COP group's overall survival was 1.063 times that of the TOP group (95% confidence interval = 0.24, 4.71). There were no significant differences between the TOP and COP groups in maternal survival (p = 0.964). Thirty-three of the infants of patients with CCIP were healthy at the end of the follow-up period, with a median age of 18 ± 2.8 months. Conclusions: Most patients with CCIP had not been screened for cervical cancer in over 5 years. The oncologic outcomes of the TOP and COP groups were similar. A platinum-based neoadjuvant chemotherapy regimen could be a favorable choice for the management of CCIP during the second and third trimesters of pregnancy.
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Affiliation(s)
- Mingzhu Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Yun Zhao
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Mingrong Qie
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, China
| | - Youzhong Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Shandong, China
| | - Longyu Li
- Department of Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nan Chang, China
| | - Bei Lin
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ruixia Guo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhixue You
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ruifang An
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi 'An Jiaotong University, Xi'an, China
| | - Jun Liu
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Zhijun Zhang
- Department of Obstetrics and Gynecology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Hui Bi
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Ying Hong
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Shufang Chang
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guoli He
- Department of Obstetrics and Gynecology, Hainan General Hospital, Hainan, China
| | - Keqin Hua
- Department of Obstetrics and Gynecology, The Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - Qi Zhou
- Department of Gynecology Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Qinping Liao
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Yue Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Jianliu Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Xiaoping Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Lihui Wei
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
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Wang Q, Zhang W, Cai H, Cao Y. Understanding the perceptions of Chinese women of the commercially available domestic and imported HPV vaccine: A semantic network analysis. Vaccine 2020; 38:8334-8342. [PMID: 33190947 DOI: 10.1016/j.vaccine.2020.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/08/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND A domestic human papillomavirus (HPV) vaccine, Cecolin, that protects against HPV strains 16 and 18 was introduced to the Chinese market at a relatively low price in May 2020.This study has explored Chinese women's perceptions of both domestic and imported HPV vaccines, which differ in price and valency. METHODS Sentiment analysis and semantic network analyses were performed based on a sample of 45,729 domestic HPV vaccine-related posts from females on the Sina Weibo between April 17 and May 2, 2020. The geographic distribution was also analyzed based on the users' locations, which were retrieved from the database. RESULTS Most of the posts were positive and neutral (85%), although 15% were negative (e.g., expressions of anger, sadness, fear and disgust). Semantic analyses of the negative posts revealed that Chinese women generally had positive attitudes towards the HPV vaccine and were willing to be vaccinated. However, obvious geographical variations were identified. Women who lived in economically developed areas expressed a stronger desire to obtain imported quadrivalent or nonavalent vaccines due to concerns regarding effectiveness and quality. The women expressed disgust and anger mainly regarding difficulties in making an appointment, age restrictions for the nonavalent vaccine and gender restrictions. However, the population targeted by the domestic vaccine, namely women who lived in economically undeveloped areas and had relatively low incomes, had a low awareness of the HPV vaccine. CONCLUSION Government should provide programs, which educate females that bivalent HPV vaccine can offer protection against the majority of high-risk HPV types. Increasing awareness of the domestic vaccine among the population in economically undeveloped areas and provision of free domestic bivalent HPV vaccination/screening for low-income high-risk women would help to prevent cervical carcinoma. This issue also depends on rebuilding trust and repairing damage to the relationship between government/domestic vaccine manufacturers and the public.
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Affiliation(s)
- Qi Wang
- School of Industrial Design, Hubei University of Technology, 28 Nanli Road, Wuhan 430068, PR China
| | - Wen Zhang
- School of Journalism and Culture Communication, Zhongnan University of Economics and Law, 182 Nanhu Avenue, Wuhan 430073, PR China.
| | - Hongning Cai
- Department of Gynecological Oncology, Hubei Maternal and Child Health Care Hospital, Wuhan 430070, Hubei, PR China
| | - Yuan Cao
- Cloud-clone Diagnostic Reagents Institute, Wuhan 430056, Hubei, PR China
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Lin W, Chen B, Wu B, Yuan S, Zhong C, Huang W, Hu H, Liu Z, Wang Y. Cervical Cancer Screening Rate and Willingness among Female Migrants in Shenzhen, China: Three-Year Changes in Citywide Surveys. Cancer Res Treat 2020; 53:212-222. [PMID: 32878425 PMCID: PMC7812020 DOI: 10.4143/crt.2020.219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023] Open
Abstract
Purpose This study attempted to detect the changes of cervical cancer screening rate and willingness among female migrants, and the associated socio-demographic factors in Shenzhen city. Materials and Methods Two citywide surveys were conducted using a multistage random cluster sampling method in 2011 and 2014, respectively. Data on demographic characteristics, screening participation, and willingness to screen were collected. Logistic regression models were applied to detect possible associated socio-demographic characteristics, and their variations with survey years. Results In total, 12,017 female migrants were enrolled, with a mean age (standard deviation) of 36.73 (6.55) years. From 2011 to 2014, the screening rate increased (25.8% vs. 35.1%, p < 0.001), while the willingness to screen remained stable (82.2% vs. 82.8%, p=0.46). Overall, socio-demographic characteristics of female migrants, including age, marital status, education, monthly income, employment, and medical insurance, were found to be positively associated with screening participation. Similar impacts in relation to willingness were observed except for age. However, these associations varied with survey years, mainly in the contributions of education and monthly income to screening participation, as well as age, monthly income, and medical insurance to willingness of being screened. Conclusion Identifying changes of associated socio-demographic factors precisely is warranted of necessity, which provides novel clues to adjust targeted actions regularly in promoting cervical cancer screening participation among female migrants in Shenzhen.
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Affiliation(s)
- Wei Lin
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bin Chen
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bo Wu
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Shixin Yuan
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Chuyan Zhong
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Weikang Huang
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Haiyan Hu
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Department of Gynecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Zhihua Liu
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Department of Gynecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Yueyun Wang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
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Exploring Chinese College Students' HPV Awareness, Knowledge, Attitudes, and Intent of HPV Vaccination: a Qualitative Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 36:1211-1218. [PMID: 32314310 DOI: 10.1007/s13187-020-01750-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Human papillomavirus (HPV) infection is the world's most prevalent sexually transmitted infection and causes cancers. In China, about 47,739 deaths occur annually from HPV-related cervical cancer, and this number continues to increase. HPV vaccines have shown promising results in preventing HPV-associated cancers; however, the vaccination rate in Chinese college students remains extremely low. This qualitative research explored Chinese college students' HPV-related awareness, knowledge, attitudes and beliefs, and their vaccination intention as well as the strategies promoting vaccination in China. We conducted four focus groups with 18 male and 20 female students; prompts were developed based on the health belief model (HBM). Discussions were audiotaped, transcribed, and translated from Chinese to English by three bilingual researchers. Content analysis of the data revealed eight themes addressing HBM. Participants demonstrated high awareness (71% had heard of HPV) with limited knowledge. They perceived very low risks of being infected but expressed high vaccination intention if the cost was covered by the government. Participants identified reasons that facilitate and prevent vaccination and proposed culturally and developmentally congruent strategies to promote vaccination in China. It is essential to address facilitators and barriers at individual, societal, political, and cultural levels to promote HPV vaccination in Chinese college students.
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Wanderley MDS, Sobral DT, Levino LDA, Marques LDA, Feijó MS, Aragão NRC. Students' HPV vaccination rates are associated with demographics, sexuality, and source of advice but not level of study in medical school. Rev Inst Med Trop Sao Paulo 2019; 61:e70. [PMID: 31859847 PMCID: PMC6922017 DOI: 10.1590/s1678-9946201961070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/19/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to explore how medical students differ regarding the HPV
vaccination status according to their demographics, sexuality, medical school
year and sources of information regarding the vaccine. The cross-sectional
survey included 379 participants from medical school year 1 to 6, in a medical
school in Brasilia. Statistical analyses of the data obtained from a
questionnaire analyzed contingency tables and highlighted odds ratios effect
sizes. The results showed that among all the participants, 80 (21.1%) were
vaccinated against HPV, 215 (58.7%) were not vaccinated but wanted to be and 84
(22.2%) were neither vaccinated nor wanted to be vaccinated. . Female gender
(OR= 5.88, 95% CI 3.36-10.30), parental advice (OR= 6.95, 95% CI= 3.97-12.16),
and absence of sexual initiation before 16 years of age (OR= 3.04, 95% CI=
1.05-8.77) were positively associated with HPV-vaccinated students. In parallel,
female gender (OR= 4.74, 95% CI= 2.38-9.44), parental advice (OR= 3.50, 95%
CI=1.20-10.22), and reporting two or more recent sexual partners (OR= 2.03, 95%
CI= 1.06-3.88) were positively associated with the intention to be vaccinated
among unvaccinated students. The high cost of the vaccine was perceived as a
barrier among those respondents who wished to be vaccinated. Additionally, among
the 84 (81.3% male) students who admitted unwillingness to be vaccinated,
approximately two-thirds cited the feeling to be safe, lack of counseling, or
low efficacy of the vaccine as the reasons for their reluctance. In conclusion,
vaccination coverage was low among these medical students. Nevertheless, female
gender, personal advice, and safe sex were the main factors associated with
higher levels of vaccination and vaccine acceptance.
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Affiliation(s)
- Miriam da Silva Wanderley
- Universidade de Brasília, Faculdade de Medicina, Área de Ginecologia e Obstetrícia, Brasília, Brazil
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Farazi PA, Siahpush M, Michaud TL, Kim J, Muchena C. Awareness of HPV and Cervical Cancer Prevention Among University Health Sciences Students in Cyprus. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:685-690. [PMID: 29629509 DOI: 10.1007/s13187-018-1356-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cervical cancer is preventable; however, despite the existence of primary and secondary means of prevention, its incidence is still higher in certain socioeconomic groups and countries, suggesting gaps in cervical cancer prevention. The objective of this study was to evaluate the knowledge and awareness of health sciences university students in Cyprus regarding HPV and cervical cancer in order to better guide the future development of educational programs to improve cervical cancer prevention. This was a cross-sectional study of 178 university health sciences students in Cyprus using a validated questionnaire on HPV and cervical cancer prevention. Analysis of the completed questionnaires revealed moderate levels of knowledge and awareness with an overall mean score of 23.32 out of 33 on HPV and 8.12 out of 13 on cervical cancer, a score of 9.25 out of 14 on HPV vaccines, and a score of 5.93 out of 9 on cervical cancer screening. Older students achieved higher scores compared to younger students (mean score of 6.76 for 18-22 years old, 9.44 for 23-28 years old, and 10.25 for 29-38 years old; p < 0.001). The study found several gaps in the students' knowledge and awareness on cervical cancer prevention. We suggest the design of education programs targeting this population possibly by incorporation of cervical cancer prevention education within students' curriculum to increase knowledge such that the spread of the virus is minimized and these health sciences students are prepared to educate their communities as part of their future practice in health professions.
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Affiliation(s)
- Paraskevi A Farazi
- College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Mohammad Siahpush
- College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Tzeyu L Michaud
- College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Jungyoon Kim
- College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Chenai Muchena
- University of Nicosia, 46 Makedonitissas Ave, Nicosia, Cyprus
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12
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Shetty S, Prabhu S, Shetty V, Shetty AK. Knowledge, attitudes and factors associated with acceptability of human papillomavirus vaccination among undergraduate medical, dental and nursing students in South India. Hum Vaccin Immunother 2019; 15:1656-1665. [PMID: 30648913 DOI: 10.1080/21645515.2019.1565260] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose: To evaluate knowledge, attitudes and factors associated with acceptability of human papillomavirus (HPV) vaccine among undergraduate medical, dental, and nursing students in South India. Methods: Using a post-test study design, a convenience sample of 988 students (age 18-26 years) were surveyed. The primary outcome was vaccine acceptability (likely to intend to receive the vaccine). Bivariate analysis using Chi-Square test of independence and multivariate binary logistic regression analysis was used to examine factors associated with vaccine acceptability. Results: Out of 988 students surveyed, majority had heard about cervical cancer (95%), HPV (89.3) or genital warts(77.5). Only 59.7% had heard of HPV vaccine prior to the survey; 65.2% intended to receive the vaccine and 68.3% were willing to recommend the vaccine to others. Participants aged <22 years were less likely to accept the vaccine (OR:0.85, CI:0.76-0.96) compared with participants aged older than 22 years. Medical students (OR:1.12, CI:1.03-1.23), students who reported alcohol use (OR:1.15, CI:1.03-1.29) and those with moderate knowledge scores were more likely to intend to receive the vaccine (OR:1.14, CI:1.04-1.24), compared to others. On multivariate analysis, only course (OR 1.366, CI 1.016-1.835) and attitude score (OR 4.17; CI 2.12-8.2) were statistically associated with intention to receive the HPV vaccine. Conclusion: Two-thirds of students intended to receive the HPV vaccine. Although the overall awareness of the HPV-related disease and prevention is good, considerable knowledge gaps exists in many areas suggesting that that more education about HPV disease and benefits of vaccination should be included in the undergraduate medical school curriculum.
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Affiliation(s)
- Seemitha Shetty
- a Department of Microbiology, K.S. Hegde Medical Academy (KSHEMA) , Mangaluru , India
| | - Sumathi Prabhu
- b Department of Mathematics, Manipal Institute of Technology , Manipal , India
| | - Veena Shetty
- a Department of Microbiology, K.S. Hegde Medical Academy (KSHEMA) , Mangaluru , India
| | - Avinash K Shetty
- c Department of Pediatrics, Wake Forest School of Medicine and Brenner Children's Hosptial , Winston-Salem , NC , USA
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Li G, Wang Y, Tan G. The construction of EpCAM/vimentin-PLGA/lipid immunomagnetic microspheres and the isolation of circulating tumor cells from lung cancer. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2018; 11:5561-5570. [PMID: 31949643 PMCID: PMC6963091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 10/25/2018] [Indexed: 06/10/2023]
Abstract
This study aims to investigate the isolation effect of the epithelial cell adhesion molecule (EpCAM) and the vimentin antibody PLGA/lipid magnetic microsphere on the isolation and identification of lung cancer circulating tumor cells (CTC) in the isolation and identification system of lung cancer CTC. The synthesis of the magnetic microsphere was achieved by the composite package of Fe3O4 magnetite nanoparticles with poly (lactic-co-glycolic acid) carboxylic acid endcap (PLGA-COOH) and octadecyl quaternized carboxymethyl chitosan (OQC), immunomagnetic microspheres (IMS) was prepared by linking an EpCAM antibody and a vimentin antibody. Blood samples of tumor-bearing nude mice (A549 lung cancer cells) were collected. Through a separation technique, the CTCs were captured by the EpCAM immunomagnetic microspheres (EpCAM-MS) and vimentin immunomagnetic microspheres (Vim-MS), and the cells were then counted and compared with the pathological condition of the tumor tissues. The results showed that self-prepared EpCAM-MS and Vim-MS could effectively capture lung cancer CTC and match the pathological findings.
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Affiliation(s)
- Guolei Li
- Department of Cardio-Thoracic Surgery, Hebei Province Hospital of Chinese MedicineShijiazhuang, Hebei Province, China
| | - Yun Wang
- Department of Medical Ultrasonics, The Third Hospital of Hebei Medical UniversityShijiazhuang, Hebei Province, China
| | - Guoliang Tan
- Department of Cardio-Thoracic Surgery, Hebei Province Hospital of Chinese MedicineShijiazhuang, Hebei Province, China
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Dong B, Sun P, Ruan G, Huang W, Mao X, Kang Y, Pan D, Lin F. Type-specific high-risk human papillomavirus viral load as a viable triage indicator for high-grade squamous intraepithelial lesion: a nested case- control study. Cancer Manag Res 2018; 10:4839-4851. [PMID: 30425576 PMCID: PMC6205532 DOI: 10.2147/cmar.s179724] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose Currently, the associations between type-specific high-risk human papillomavirus (HR-HPV) viral loads and cervical lesions are still inconsistent. We aimed to assess the type-specific HR-HPV viral load as a risk triage indicator for development of high-grade squamous intraepithelial lesion or worse (≥HSIL). Patients and methods A total of 19,446 women who underwent primary screening for cervical cancer using Cervista® HR-HPV and cytology assays were enrolled. The viral loads of 1,396 HR-HPV-positive specimens confirmed by Cervista® assay were detected by BioPerfectus Multiplex Real-Time PCR assay. The correlation between viral loads and cervical lesions was analyzed. The optimal cutoffs of individual HR-HPV viral loads used to predict ≥HSIL were determined from the receiver operating characteristic curve. A logistic regression model was used to analyze the relationship between covariates and the probability of ≥HSIL. Results The viral loads of HPV-16, -31, -33, -52, and -58 were positively correlated with the severity of the cervical lesion, which was significantly elevated in patients with ≥HSIL, whereas those of HPV-18, -45, -56, -59, and other types were not. The optimal cutoffs of the log10-transformed viral loads for HPV-16, -31, -33, -52, and -58 in identifying ≥HSIL were 4.26, 4.46, 4.48, 4.36, and 4.26 copies per 10,000 cells, respectively. Furthermore, multivariate analysis indicated that type-specific viral loads of HPV-16, -31, -33, -52, and -58 exceeding the cutoffs could be independent risk factors for the incidence of ≥HSIL. Conclusion The BioPerfectus Multiplex Real-Time PCR viral load assay provides viable triage for ≥HSIL when using appropriate cutoff levels.
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Affiliation(s)
- Binhua Dong
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, P.R. China,
| | - Pengming Sun
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, P.R. China, .,Department of Gynecology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, P.R. China,
| | - Guanyu Ruan
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, P.R. China,
| | - Weiyi Huang
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, P.R. China,
| | - Xiaodan Mao
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, P.R. China,
| | - Yafang Kang
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, P.R. China,
| | - Diling Pan
- Department of Pathology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, P.R. China
| | - Fen Lin
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, P.R. China,
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15
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Awareness of human papilloma virus and cervical cancer prevention among Greek female healthcare workers. Eur J Cancer Prev 2018; 26:330-335. [PMID: 27254169 DOI: 10.1097/cej.0000000000000254] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The incidence rate of cervical cancer varies by geographic region, with less developed regions showing the highest rates. All risk factors for cervical cancer are actually preventable if appropriate lifestyle changes are adopted. In addition, vaccines protecting against the majority of human papilloma virus (HPV) high-risk types have been developed. Even though cervical cancer is preventable, not all women are aware of this or how it can be prevented. Thus, it is essential for every nation to assess the level of knowledge among women of cervical cancer and HPV prevention. In this work, we assessed the level of awareness and attitudes of Greek female healthcare workers on cervical cancer and HPV prevention through the delivery of a validated questionnaire between March and June 2012 in three hospitals in Greece. Our results show that there exist gaps in the knowledge of women on this topic, especially in terms of the newest information on cervical cancer prevention through HPV testing and vaccination. In fact, only 80% of surveyed women knew about the existence of HPV testing. We propose that more information needs to be transmitted to Greek women and men on HPV testing and vaccination. Even though the incidence of cervical cancer is not extremely high in Greece, this number can easily change, especially in the face of the economic crisis and the increasing rates of migration, which can result in higher rates of HPV infection in the population if no measures for HPV prevention are implemented.
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16
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Liu A, Ho FK, Chan LK, Ng JY, Li SL, Chan GC, Leung TF, Ip P. Chinese medical students' knowledge, attitude and practice towards human papillomavirus vaccination and their intention to recommend the vaccine. J Paediatr Child Health 2018; 54:302-310. [PMID: 28876498 DOI: 10.1111/jpc.13693] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 06/22/2017] [Accepted: 07/30/2017] [Indexed: 11/29/2022]
Abstract
AIM The human papillomavirus (HPV) vaccine is effective in preventing cervical cancer, but its global uptake rate in vulnerable populations is unsatisfactory. Physician's recommendation is an important determinant for vaccine uptake, but we have limited understanding on the contributing factors of physician's recommendation. This study investigated whether the knowledge, attitudes and vaccination status of medical students would affect their intention to recommend HPV vaccination. METHODS This is a population-representative survey of medical schools in Hong Kong. RESULTS Participants included 1022 Chinese medical students (46.9% of all in Hong Kong; 46.3% female). Better HPV-related knowledge and a more positive attitude towards HPV vaccination were important factors predicting vaccine uptake and intention to recommend. HPV vaccination status and intention to receive the vaccine were positively associated with intention to recommend among females. CONCLUSION Better HPV-related medical education may be a feasible way to promote the HPV vaccine in regions without universal coverage. Medical students who have not received the HPV vaccine should also be encouraged to receive the vaccine.
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Affiliation(s)
- Anthony Liu
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Frederick K Ho
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Lily Kl Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Joanne Yw Ng
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Sophia L Li
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Godfrey Cf Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Ting Fan Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
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Sun P, Song Y, Ruan G, Mao X, Kang Y, Dong B, Lin F. Clinical validation of the PCR-reverse dot blot human papillomavirus genotyping test in cervical lesions from Chinese women in the Fujian province: a hospital-based population study. J Gynecol Oncol 2017; 28:e50. [PMID: 28657218 PMCID: PMC5540716 DOI: 10.3802/jgo.2017.28.e50] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 03/11/2017] [Accepted: 04/09/2017] [Indexed: 11/30/2022] Open
Abstract
Objective To determine the clinical significance of the polymerase chain reaction (PCR)-reverse dot blot (RDB) human papillomavirus (HPV) genotyping assay in cervical cancer screening. Methods A total of 10,442 women attending the Fujian Provincial Maternity and Children's Health Hospital were evaluated using the liquid-based cytology (thinprep cytologic test [TCT]) and the PCR-RDB HPV test. Women with HPV infection and/or abnormal cytology were referred for colposcopy and biopsy. For HPV DNA sequencing, 120 specimens were randomly selected. Pathological diagnosis was used as the gold standard. Results Using the PCR-RDB HPV test, overall HPV prevalence was 20.57% (2,148/10,442) and that of high-risk (HR)-HPV infection was 18.68% (1,951/10,442). There was 99.2% concordance between HPV PCR-RDB testing and sequencing. In this studied population, the most common HR-HPV types were HPV-16, -52, -58, -18, -53, -33, and -51, rank from high to low. HPV-16, -18, -58, -59, and -33 were the top 5 prevalent genotypes in cervical cancer but HPV-16, -18, -59, -45, and -33 were the top 5 highest risk factors for cancer (odds ratio [OR]=34.964, 7.278, 6.728, 6.101, and 3.658; all p<0.05, respectively). Among 10,442 cases, 1,278 had abnormal cytology results, of which, the HR-HPV positivity rate was 83.02% (1,061/1,278). To screen for cervical cancer by PCR-RDB HPV testing, when using CIN2+, CIN3+, and cancer as observed endpoints, the sensitivity was 90.43%, 92.61%, and 94.78% and the negative predictive value (NPV) was 99.06%, 99.42%, and 99.78%, respectively. PCR-RDB HPV and TCT co-testing achieved the highest sensitivity and NPV. Conclusion For cervical cancer screening, the PCR-RDB HPV test can provide a reliable and sensitive clinical reference.
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Affiliation(s)
- Pengming Sun
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China.,Department of Gynecology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China.
| | - Yiyi Song
- Department of Gynecology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
| | - Guanyu Ruan
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
| | - Xiaodan Mao
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
| | - Yafang Kang
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
| | - Binhua Dong
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
| | - Fen Lin
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
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Afonso NM, Kavanagh MJ, Swanberg SM, Schulte JM, Wunderlich T, Lucia VC. Will they lead by example? Assessment of vaccination rates and attitudes to human papilloma virus in millennial medical students. BMC Public Health 2017; 17:35. [PMID: 28056900 PMCID: PMC5217643 DOI: 10.1186/s12889-016-3969-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 12/20/2016] [Indexed: 02/03/2023] Open
Abstract
Background Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. It is also well established that HPV viruses are responsible for a variety of cancers. Little is known about the prevailing knowledge and attitudes toward the HPV vaccine in our future healthcare providers, a majority of whom were among the first in the target age group to receive the vaccine; the same vaccine that they will in turn be expected to recommend to their patients. The aims of this pilot study were to examine the HPV vaccination rate among medical students and determine their knowledge about HPV and attitudes toward vaccination. Methods To aid in the development of an HPV educational intervention, a needs assessment survey was administered to discover medical students’ knowledge and attitudes toward the HPV vaccine. All medical students at a Midwestern US medical school were invited to complete the survey. Results Two hundred fourteen of 390 medical students completed the survey with 44% having been previously vaccinated. Although 82% of all respondents believed they would recommend the vaccine to family and friends, only 40% felt knowledgeable about the vaccine and 40% felt comfortable counseling patients. More positive attitudes and better knowledge scores were found in fully vaccinated students compared to non-vaccinated students. Provider recommendation was strongly associated with HPV vaccination status. Conclusions This study revealed the unique perspectives of U.S. millennial medical students as the first group of future healthcare providers to have personally encountered the HPV vaccine. Overall, students’ knowledge as well as their comfort level in counseling patients was lacking. This assessment has guided the development of targeted educational interventions to address knowledge gaps and prepare students to appropriately discuss the vaccine with patients and parents and help protect young people from life threatening cancers.
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Affiliation(s)
- Nelia M Afonso
- Department of Biomedical Sciences, Oakland University William Beaumont School of Medicine, 2200 North Squirrel Rd., Rochester, MI, 48309, USA. .,Clinical Skills Training & Simulation Center, Oakland University William Beaumont School of Medicine, 44300 Dequindre Rd., Sterling Heights, MI, 48314, USA.
| | - Maurice J Kavanagh
- Clinical Skills Training & Simulation Center, Oakland University William Beaumont School of Medicine, 44300 Dequindre Rd., Sterling Heights, MI, 48314, USA
| | - Stephanie M Swanberg
- Department of Biomedical Sciences, Oakland University William Beaumont School of Medicine, 2200 North Squirrel Rd., Rochester, MI, 48309, USA
| | - Jeanne M Schulte
- Clinical Skills Training & Simulation Center, Oakland University William Beaumont School of Medicine, 44300 Dequindre Rd., Sterling Heights, MI, 48314, USA
| | - Tracy Wunderlich
- Department of Medical Education, Oakland University William Beaumont School of Medicine, 2200 North Squirrel Rd., Rochester, MI, 48309, USA
| | - Victoria C Lucia
- Department of Biomedical Sciences, Oakland University William Beaumont School of Medicine, 2200 North Squirrel Rd., Rochester, MI, 48309, USA
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Zhang Y, Wang Y, Liu L, Fan Y, Liu Z, Wang Y, Nie S. Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies. BMC Public Health 2016; 16:216. [PMID: 26936076 PMCID: PMC4776385 DOI: 10.1186/s12889-016-2873-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 02/16/2016] [Indexed: 11/25/2022] Open
Abstract
Background The human papillomavirus (HPV) vaccines have been widely introduced in immunization programs worldwide, however, it is not accepted in mainland China. We aimed to investigate the awareness and knowledge about HPV vaccines and explore the acceptability of vaccination among the Chinese population. Methods A meta-analysis was conducted across two English (PubMed, EMBASE) and three Chinese (China National Knowledge Infrastructure, Wan Fang Database and VIP Database for Chinese Technical Periodicals) electronic databases in order to identify HPV vaccination studies conducted in mainland China. We conducted and reported the analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Fifty-eight unique studies representing 19 provinces and municipalities in mainland China were assessed. The pooled awareness and knowledge rates about HPV vaccination were 15.95 % (95 % CI: 12.87–19.29, I2 = 98.9 %) and 17.55 % (95 % CI: 12.38–24.88, I2 = 99.8 %), respectively. The female population (17.39 %; 95 % CI: 13.06–22.20, I2 = 98.8 %) and mixed population (18.55 %; 95 % CI: 14.14–23.42, I2 = 98.8 %) exhibited higher HPV vaccine awareness than the male population (1.82 %; 95 % CI: 0.50–11.20, I2 = 98.5 %). Populations of mixed ethnicity had lower HPV vaccine awareness (9.61 %; 95 % CI: 5.95–14.03, I2 = 99.0 %) than the Han population (20.17 %; 95 % CI: 16.42–24.20, I2 = 98.3 %). Among different regions, the HPV vaccine awareness was higher in EDA (17.57 %; 95 % CI: 13.36–22.21, I2 = 98.0 %) and CLDA (17.78 %; 95 % CI: 12.18–24.19, I2 = 97.6 %) than in WUDA (1.80 %; 95 % CI: 0.02–6.33, I2 = 98.9 %). Furthermore, 67.25 % (95 % CI: 58.75–75.21, I2 = 99.8 %) of participants were willing to be vaccinated, while this number was lower for their daughters (60.32 %; 95 % CI: 51.25–69.04, I2 = 99.2 %). The general adult population (64.72 %; 95 % CI: 55.57–73.36, I2 = 99.2 %) was more willing to vaccinate their daughters than the parent population (33.78 %; 95 % CI: 26.26–41.74, I2 = 88.3 %). Safety (50.46 %; 95 % CI: 40.00–60.89, I2 = 96.6 %) was the main concern about vaccination among the adult population whereas the safety and efficacy (68.19 %; 95 % CI: 53.13–81.52, I2 = 98.6 %) were the main concerns for unwillingness to vaccinate their daughters. Conclusions Low HPV vaccine awareness and knowledge was observed among the Chinese population. HPV vaccine awareness differed across sexes, ethnicities, and regions. Given the limited quality and number of studies included, further research with improved study designis necessary. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2873-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yanru Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Ying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. .,Mental Health Center, Renmin Hospital of Wuhan University, Hubei Provincial Mental Health Center Wuchang District, Wuhan, Hubei, P. R. China.
| | - Li Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yunzhou Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Zhihua Liu
- Shenzhen Maternity and Child Health Hospitals, Shenzhen, Guangdong, P. R. China.
| | - Yueyun Wang
- Shenzhen Maternity and Child Health Hospitals, Shenzhen, Guangdong, P. R. China.
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Kong Q, Wang W, Li P. Regulator role of HPV E7 protein on miR-21 expression in cervical carcinoma cells and its functional implication. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:15808-15813. [PMID: 26884851 PMCID: PMC4730064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 10/25/2015] [Indexed: 06/05/2023]
Abstract
Cervical cancer is the second leading malignant tumor in women. Human papillomavirus 16 (HPV16) is one risk factor for cervical cancer, with its expressed E7 protein can facilitate the transformation of cervical epithelial cells. MicroRNA-21 (miR-21) is one important tumor growth regulatory factor involving in angiogenesis, tumor invasion and metastasis. This study thus aimed to investigate the role of high-risk HPV16 E7 protein in regulating miR-21 expression in cervical carcinoma and its related functions. Hela cells were transfected with pcDNA-HPV16 E7 expressing vectors. The expression level of E7 was determined by Western blotting, while miR-21 level was quantified by real-time PCR. The alternation of tumor cell proliferation is determined by transfecting miR-21 inhibitor into E7-overexpressing Hela cells. Cell apoptosis was studied by caspase-3 assay, while cell invasion was illustrated in Transwell chamber. The overexpression of HPV E7 protein facilitated the expression of miR-21, which potentiated Hela cell proliferation and invasion. The inhibition of miR-21 in E7-overexpressin Hela cells can inhibit both proliferation and invasion, but without significant effects on caspase-3 activity. HPV16 E7 protein can up-regulate host miR-21 expression, thus elevating cervical carcinoma cell growth, proliferation and invasion. Therefore, E7 protein is one critical factor in occurrence and progression of cervical carcinoma.
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Affiliation(s)
- Qingqin Kong
- Department of Obstetrics and Gynecology, Linyi People's Hospital Linyi City, Shandong Province, China
| | - Wenfeng Wang
- Department of Obstetrics and Gynecology, Linyi People's Hospital Linyi City, Shandong Province, China
| | - Ping Li
- Department of Obstetrics and Gynecology, Linyi People's Hospital Linyi City, Shandong Province, China
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Knowledge and attitude of Uyghur women in Xinjiang province of China related to the prevention and early detection of cervical cancer. World J Surg Oncol 2015; 13:110. [PMID: 25885660 PMCID: PMC4371720 DOI: 10.1186/s12957-015-0531-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/28/2015] [Indexed: 02/08/2023] Open
Abstract
Background Cervical cancer is one of the commonest causes of cancer-related deaths worldwide. The prevalence rate of cervical cancer in Uyghur women in Xinjiang Autonomous Region of China has been remarkably higher than the ethnic groups living in the same region. This study aimed to assess the knowledge level and attitude of cervical cancer and its issues among the Uyghur women in Xinjiang province of China. Methods A cross-sectional interview-based survey of 5,000 Uyghur women was developed from 2013 to 2014 in Xinjiang autonomous region, to assess their knowledge and perception of cervical cancer and its issues. The collection of data was based on the questionnaire items. Results According to the questionnaire items, we collected a data for 5,000 participants. A very small proportion of participants had heard of the cervical cancer, human papillomavirus (HPV), and HPV vaccine, that is, 27.0%, 13.0% and, 6.0%, respectively. According to the demographic characteristics, women aged 31 to 40 years were more aware of the knowledge of cervical cancer (32.9%), HPV (17.8%), and HPV vaccine (9.1%), and women with undergraduate or higher educational level had more knowledge of cervical cancer (30.0%), HPV (21.0%), and HPV vaccine (9.7%). Conclusions From our study, we concluded that Uyghur women need more information about cervical cancer and its risk factors. Lack of the related knowledge about cervical cancer may be one of the important factors for high incidence rate of cervical cancer in Uyghur population. In order to reduce the incidence rate and mortality of cervical cancer in Uyghur women and to make extensive health education to raise awareness of cervical cancer and HPV is strongly needed than prophylactic vaccination.
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Rasul VH, Cheraghi MA, Behboodi Moqadam Z. Influencing factors on cervical cancer screening from the Kurdish women's perspective: A qualitative study. J Med Life 2015; 8:47-54. [PMID: 28255397 PMCID: PMC5327709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/27/2015] [Indexed: 11/18/2022] Open
Abstract
Aim:This study was aimed to explore and describe the Kurdish women's perception of cervical cancer screening. Methods: A qualitative design based on a conventional content analysis approach. Purposive sampling was applied to 19 women chosen, who had a Pap smear or refused to have one. The study was performed in the Kurdistan Region, Iraq. Semi-structure din-depth individual interviews were carried out to collect data. Results: Four main themes including conflict, belief, and awareness about cervical cancer screening and socio-cultural factors emerged during data analysis Conclusions: Cervical cancer has a high mortality rate in the developing countries. However, only a few Kurdish women participated in the cervical cancer screening in the Kurdistan Region, Iraq. Understanding the factors associated with the women's perception of cervical cancer could guide future educational planning and clinical interventions improve the cervical cancer screening.
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Affiliation(s)
- V H Rasul
- Faculty of Nursing and Midwifery, International Campus, Tehran University of Medical Sciences, Tehran, Iran; Shaqlawa Techniqueal Institute, Erbil Polytechnique University, Kurdistan Region, Iraq
| | - M A Cheraghi
- Faculty of Nursing and Midwifery, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Z Behboodi Moqadam
- Reproductive Health, Faculty of Nursing and Midwifery, International Campus, Tehran University of Medical Sciences, Tehran, Iran
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