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Shrateh ON, Habib A, Jalamneh B, Omar BM, Naasan M. The level of medical students' knowledge regarding the prevention of cervical cancer. Ann Med Surg (Lond) 2024; 86:2591-2597. [PMID: 38694304 PMCID: PMC11060242 DOI: 10.1097/ms9.0000000000001935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/29/2024] [Indexed: 05/04/2024] Open
Abstract
Background In Palestine, cervical cancer is the third most common gynaecological cancer, exhibiting higher mortality rates compared to regional counterparts. Late-stage diagnosis and limited awareness contribute to this disparity. This study aims to assess the awareness of Palestinian medical students regarding cervical cancer prevention. Methods A questionnaire-based survey involving 532 medical students from various Palestinian universities was conducted between October 2023 and December 2023. The survey encompassed closed-ended quantitative and demographic questions distributed through social media. Results The study was carried out on a group of 532 medical students (66.3% women and 33.6% men), (average age 21.7 years). Most students (77.7%) knew that the main risk factor for cervical cancer was human papillomavirus (HPV) infection. Participants doing the internship had the greatest knowledge, whereas students from the first year had the poorest knowledge about the main risk factors for cancer of the cervix. Only about half, 50.2% of all students, knew that in Palestine, there is no screening program. 84.4% of students correctly indicated that the cervical cancer screening test is a pap smear test. 41.4% of respondents knew that microscopic evaluation of the exfoliated cells from the vaginal part of the cervix is the screening test for cervical cancer which is used. Only about half of the students (45.1%) knew that there were no specific early symptoms of cervical cancer. Conclusions This study highlights the need for enhanced education, particularly regarding screening program awareness, among Palestinian medical students. Addressing these knowledge gaps is crucial for effective preventive strategies.
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Affiliation(s)
| | - Ashna Habib
- Dow University of Health Sciences, Mission Road, Karachi, Pakistan
| | - Basil Jalamneh
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | | | - Mashhour Naasan
- Department of Obstetrics and Gynecology, Al-Istishari Arab Hospital, Ramallah, Palestine
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2
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Sreeramulu P, Varsha A, Kattepur AK, Aswathappa D. A questionnaire based survey to assess knowledge and practice of health care workers regarding genital hygiene: from a rural tertiary hospital in India. Hosp Pract (1995) 2022; 50:298-305. [PMID: 35980119 DOI: 10.1080/21548331.2022.2113657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
PURPOSE Maintaining good genital hygiene is an important component in reducing human papilloma virus (HPV) infections and its sequelae such as cervical pre-cancer and cancer. Awareness on the exact practice of maintaining genital hygiene is important as they are different in men and women, and both are equally important in reducing genital HPV infections. STUDY DESIGN A questionnaire based survey was undertaken to assess knowledge and practice of cervical cancer and its relationship with genital hygiene. Interns, post graduate students, consultants and nurses were invited. Domain based assessment was done. Correlation between the domains was performed using Pearson's coefficient. RESULTS 87 respondents completed the questionnaire. 6 domains on awareness of physical and genital hygiene, cervical cancer causation and prevention, health education and personal experience of cervical cancer were explored. In the awareness domains, the response was uniformly poor in 45-50% of respondents. Nurses had poor knowledge in every domain of the questionnaire. CONCLUSIONS There is an urgent need to improve and bridge the gap of knowledge and practice in hygiene and cervical cancer. This is necessary since nurses and interns are the first line for disseminating proper information to the general public. Webinars, seminars and continued medical education (CME) programs must be included in the training curricula to impart knowledge on genital hygiene and cervical cancer.
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Affiliation(s)
- Pnms Sreeramulu
- Department of General Surgery, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India.,Department of Surgical Oncology, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
| | - A Varsha
- Department of General Surgery, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India.,Department of Surgical Oncology, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
| | - Abhay K Kattepur
- Department of General Surgery, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India.,Department of Surgical Oncology, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
| | - D Aswathappa
- Department of General Surgery, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India.,Department of Surgical Oncology, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
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Elshami M, Thalji M, Abukmail H, Al-Slaibi I, Alser M, Radaydeh A, Alfuqaha A, Khader S, Khatib L, Fannoun N, Ahmad B, Kassab L, Khrishi H, Elhussaini D, Abed N, Nammari A, Abdallah T, Alqudwa Z, Idais S, Tanbouz G, Hajajreh M, Selmiyh HA, Abo-Hajouj Z, Hebi H, Zamel M, Skaik RN, Hammoud L, Rjoub S, Ayesh H, Rjoub T, Zakout R, Alser A, Abu-El-Noor N, Bottcher B. Knowledge of cervical cancer risk factors among Palestinian women: a national cross-sectional study. BMC WOMENS HEALTH 2021; 21:385. [PMID: 34727914 PMCID: PMC8561913 DOI: 10.1186/s12905-021-01510-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 10/12/2021] [Indexed: 12/24/2022]
Abstract
Background High awareness of cervical cancer (CC) risk factors is important to decrease the morbidity and mortality associated with CC. This study aimed to assess the knowledge level of Palestinian women about CC risk factors and to determine the factors associated with good knowledge. Methods This was a national cross-sectional study. Adult women from hospitals, primary healthcare centers, and public spaces of 11 governorates in Palestine were recruited using a stratified convenience sampling. A translated-into-Arabic version of the validated CC awareness measure (CeCAM) was used to assess the knowledge about the 11 CC risk factors. For each correctly identified risk factor, the participant was given one point. The total score was calculated and was categorized into three categories: poor knowledge (0–3), fair knowledge (4–7), and good knowledge (8–11). Results A total of 7223 participants completed the Arabic CeCAM (response rate = 89.3%) and 7058 questionnaires were included in the final analysis: 2655 from the Gaza Strip and 4403 from the West Bank and Jerusalem. Participants recruited from the Gaza Strip were younger, getting lower monthly incomes, and with less chronic diseases than participants recruited from the West Bank and Jerusalem. The most frequently identified risk factor was ‘having a weakened immune system’ (n = 5458, 77.3%) followed by ‘infection with a sexually transmitted infection’ (n = 5388, 76.3%). The least identified risk factor was ‘having many children’ (n = 1597, 22.6%). Only 1670 women (23.7%) had good knowledge of CC risk factors. Women living in the Gaza Strip were more likely than women living in the West Bank and Jerusalem to have good knowledge (25.2% vs 22.7%). Completing a secondary or diploma degree, being employed, and having a monthly income of ≥ 1450 NIS (around $450) were all associated with lower likelihood of having good knowledge of CC risk factors. Conversely, knowing someone with cancer was associated with higher likelihood of having good knowledge. Conclusion The overall awareness of CC risk factors was low. There is a substantial need to establish educational programs to promote Palestinian women’s awareness of CC. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01510-2.
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Affiliation(s)
- Mohamedraed Elshami
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. .,Ministry of Health, Gaza, Palestine.
| | - Mariam Thalji
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Hanan Abukmail
- Ministry of Health, Gaza, Palestine.,Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | | | - Afnan Radaydeh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Alaa Alfuqaha
- Faculty of Graduate Studies, An-Najah National University, Nablus, Palestine
| | - Salma Khader
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Lana Khatib
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Nour Fannoun
- Faculty of Pharmacy, Alazhar University of Gaza, Gaza, Palestine
| | - Bisan Ahmad
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Hiba Khrishi
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | - Deniz Elhussaini
- Faculty of Medicine, Alazhar University of Gaza, Gaza, Palestine
| | - Nour Abed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Aya Nammari
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Zaina Alqudwa
- Faculty of Medicine, Alazhar University of Gaza, Gaza, Palestine
| | - Shahd Idais
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Ghaid Tanbouz
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | | | - Hala Abu Selmiyh
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Haya Hebi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Manar Zamel
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | - Lama Hammoud
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | - Saba Rjoub
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Hadeel Ayesh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Toqa Rjoub
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Rawan Zakout
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Sun TX, Li MY, Zhang ZH, Wang JY, Xing Y, Ri M, Jin CH, Xu GH, Piao LX, Jin HL, Zuo HX, Ma J, Jin X. Usnic acid suppresses cervical cancer cell proliferation by inhibiting PD-L1 expression and enhancing T-lymphocyte tumor-killing activity. Phytother Res 2021; 35:3916-3935. [PMID: 33970512 DOI: 10.1002/ptr.7103] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/11/2021] [Accepted: 03/12/2021] [Indexed: 11/10/2022]
Abstract
The programmed cell death 1 (PD-1)/programmed death ligand 1 (PD-L1) pathway is abnormally expressed in cervical cancer cells. Moreover, PD-1/PD-L1 blockade reduces the apoptosis and exhaustion of T cells and inhibits the development of malignant tumors. Usnic acid is a dibenzofuran compound originating from Usnea diffracta Vain and has anti-inflammatory, antifungal, and anticancer activities. However, the molecular mechanism of its antitumor effects has not been fully elucidated. In this work, we first observed that usnic acid decreased the expression of PD-L1 in HeLa cells and enhanced the cytotoxicity of co-cultured T cells toward tumor cells. Usnic acid inhibited PD-L1 protein synthesis by reducing STAT3 and RAS pathways cooperatively. It was subsequently shown that usnic acid induced MiT/TFE nuclear translocation through the suppression of mTOR signaling pathways, and promoted the biogenesis of lysosomes and the translocation of PD-L1 to the lysosomes for proteolysis. Furthermore, usnic acid inhibited cell proliferation, angiogenesis, migration, and invasion, respectively, by downregulating PD-L1, thereby inhibiting tumor growth. Taken together, our results show that usnic acid is an effective inhibitor of PD-L1 and our study provide novel insights into the mechanism of its anticancer targeted therapy.
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Affiliation(s)
- Tong Xin Sun
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - Ming Yue Li
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - Zhi Hong Zhang
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - Jing Ying Wang
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - Yue Xing
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - MyongHak Ri
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - Cheng Hua Jin
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - Guang Hua Xu
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - Lian Xun Piao
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - Hong Lan Jin
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - Hong Xiang Zuo
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - Juan Ma
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
| | - Xuejun Jin
- Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, China
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Tosun H, Gul A, Yazici S. Survey on the knowledge level and attitudes of university students about human papilloma virus infection and vaccination and assessing healthy living behaviors. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01420-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Pankaj S, Kumari A, Choudhary V, Jee B. Cervical cancer in Bihar: Time to revisit the shortcomings. Indian J Cancer 2019; 55:203-204. [PMID: 30604738 DOI: 10.4103/ijc.ijc_606_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Sangeeta Pankaj
- Department of Gynecological Oncology, Regional Cancer Centre, Patna, Bihar, India
| | - Anita Kumari
- Department of Gynecological Oncology, Regional Cancer Centre, Patna, Bihar, India
| | - Vijayanand Choudhary
- Department of Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Babban Jee
- Department of Health Research, Ministry of Health and Family Welfare, Government of India, New Delhi, India
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Combined SYBR Green real-time polymerase chain reaction and microarray method for the simultaneous determination of human papillomavirus loads and genotypes. Obstet Gynecol Sci 2016; 59:489-497. [PMID: 27896251 PMCID: PMC5120068 DOI: 10.5468/ogs.2016.59.6.489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 07/04/2016] [Accepted: 07/31/2016] [Indexed: 11/16/2022] Open
Abstract
Objective The aim of this study was to describe the principle of the Cheil HPV DNA Chip assay and evaluate its accuracy. In order to quantify the human papillomavirus (HPV) load and identify HPV genotypes simultaneously, this assay combined the two methods: SYBR Green quantitative real-time polymerase chain reaction (PCR) and DNA microarray. Methods We designed novel consensus primer sets that target the conserved region of the HPV L1 gene for quantifying and detecting a broad range of HPV types by quantitative real-time PCR. Subsequently, using the PCR products, DNA microarray was performed with 36 HPV type-specific probes. To validate this method, direct sequencing and correlation analysis among HPV genotype, viral load, and cytological abnormality was performed by Cohen’s kappa values, two-sided McNemar chi-square test, Kruskal-Wallis test, and odds ratios. Results The kappa value of the Cheil HPV DNA Chip was 0.963 (95% confidence interval, 0.919 to 0.98), which was significantly higher than the value of 0.527 (95% confidence interval, 0.447 to 0.59) obtained using a conventional HPV DNA Chip. HPV16 (χ2=62.28, P<0.01), HPV33 (χ2=7.18, P<0.01), and HPV58 (χ2=9.52, P<0.01), which are classified as high-risk HPVs, were detected at significant levels in samples with high-grade lesions. And viral loads tended to be higher in groups with high odds ratios. Conclusion The Cheil HPV DNA Chip is an effective diagnostic assay for simultaneously detecting HPV genotypes and loads in cervical samples.
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Ng CJ, Teo CH, Abdullah N, Tan WP, Tan HM. Relationships between cancer pattern, country income and geographical region in Asia. BMC Cancer 2015; 15:613. [PMID: 26335225 PMCID: PMC4558762 DOI: 10.1186/s12885-015-1615-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 08/21/2015] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Cancer incidence and mortality varies across region, sex and country's economic status. While most studies focused on global trends, this study aimed to describe and analyse cancer incidence and mortality in Asia, focusing on cancer site, sex, region and income status. METHODS Age-standardised incidence and mortality rates of cancer were extracted from the GLOBOCAN 2012 database. Cancer mortality to incidence ratios (MIRs) were calculated to represent cancer survival. The data were analysed based on the four regions in Asia and income. RESULTS Cancer incidence rate is lower in Asia compared to the West but for MIR, it is the reverse. In Asia, the most common cancers in men are lung, stomach, liver, colorectal and oesophageal cancers while the most common cancers in women are breast, lung, cervical, colorectal and stomach cancers. The MIRs are the highest in lung, liver and stomach cancers and the lowest in colorectal, breast and prostate cancers. Eastern and Western Asia have a higher incidence of cancer compared to South-Eastern and South-Central Asia but this pattern is the reverse for MIR. Cancer incidence rate increases with country income particularly in colorectal and breast cancers but the pattern is the opposite for MIR. CONCLUSION This study confirms that there is a wide variation in cancer incidence and mortality across Asia. This study is the first step towards documenting and explaining the changing cancer pattern in Asia in comparison to the rest of the world.
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Affiliation(s)
- Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Chin Hai Teo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Nurdiana Abdullah
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Wei Phin Tan
- Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA.
| | - Hui Meng Tan
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
- Subang Jaya Medical Centre, 47500, Subang Jaya, Malaysia.
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Roger E, Nwosu O. Diagnosing cervical dysplasia using visual inspection of the cervix with acetic acid in a woman in rural Haiti. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:12304-11. [PMID: 25464128 PMCID: PMC4276615 DOI: 10.3390/ijerph111212304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 11/18/2014] [Accepted: 11/20/2014] [Indexed: 11/20/2022]
Abstract
Cervical cancer remains a significant cause of morbidity and mortality for women in developing countries, despite the fact that inexpensive, simple and effective screening methods are available. Visual inspection of the cervix with acetic acid (VIA) can be used as part of a "screen and treat" program to identify precancerous lesions for cryotherapy treatment. This case report details how the VIA screening test was incorporated into the care of a patient presenting to a maternal health clinic in Thomonde, Haiti which was staffed by doctors and medical students from Emory University School of Medicine in collaboration with Haiti Medishare. As demonstrated here, the VIA test requires minimal materials, can be efficiently incorporated into a physical exams, provides immediate results, and is easily demonstrated to and performed by local healthcare providers. The straightforward and sensitive VIA technique is an ideal cervical cancer screening method for resource poor areas.
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Affiliation(s)
- Elizabeth Roger
- Emory University School of Medicine, Atlanta, GA 30322, USA.
| | - Oguchi Nwosu
- Emory University School of Medicine, Atlanta, GA 30322, USA.
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Tobing MDL, Sahiratmadja E, Dinda M, Hernowo BS, Susanto H. Human Papillomavirus Genotypes Profile in Cervical Cancer Patients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Asian Pac J Cancer Prev 2014; 15:5781-5. [PMID: 25081701 DOI: 10.7314/apjcp.2014.15.14.5781] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Maringan Diapari Lumban Tobing
- Department of Obstetrics and Gynecology, Dr. Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. E-mail :
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