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Jailani AS, Balqis-Ali NZ, Tang KF, Fun WH, Samad SA, Jahaya R, Subakir NN, Ismail R, Said ZM, Sararaks S. Prevalence and sociodemographic predictors of high-risk vaginal human papillomavirus infection: findings from a public cervical cancer screening registry. BMC Public Health 2023; 23:2243. [PMID: 37964260 PMCID: PMC10644607 DOI: 10.1186/s12889-023-17132-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023] Open
Abstract
INTRODUCTION High-risk human papillomavirus (HPV) screening is vital for early cervical cancer detection and treatment. With the introduction of the national cervical cancer screening programme and screening registry in Malaysia, there is a need to monitor population-based HPV screening uptake and high-risk HPV prevalence as part of cervical cancer surveillance. OBJECTIVE To determine the prevalence and sociodemographic factors predicting high-risk HPV infection in Malaysia based on a public, community-based cervical cancer screening registry targeting women at risk of getting HPV infection. METHODS The study used data from the Malaysian cervical cancer screening registry established by the Family Health Development Division from 2019 to 2021. The registry recorded sociodemographic data, HPV test details and results of eligible women who underwent HPV screening at public primary healthcare facilities. A vaginal sample (via self-sampling or assisted by a healthcare provider) was used for DNA extraction for HPV detection and genotyping. Registry data were extracted and analysed to determine prevalence estimates of high-risk HPV infection. Multifactorial logistic regression analysis was conducted to determine predictors of high-risk HPV infection. All analyses were performed using Stata version 14. RESULTS The programme screened a total of 36,738 women during the study period. Women who attended the screening programme were mainly from urban areas, aged 30-39 years, and of Malay ethnicity. The prevalence of high-risk HPV infection was 4.53% among women screened, with the yearly prevalence ranging from 4.27 to 4.80%. A higher prevalence was observed among urban settling women, those aged 30-49 years, those of Indian ethnicity, and those without children. The results from logistic regression showed that women from urban areas, lower age groups, of Indian or Chinese ethnicity, and who are self-employed were more likely to be infected with high-risk HPV. CONCLUSION Targeted and robust strategies to reach identified high-risk groups are needed in Malaysia. In addition, the registry has the potential to be expanded for an improved cervical cancer elimination plan. TRIAL REGISTRATION Trial registration number: NMRR ID-22-00187-DJU.
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Affiliation(s)
- Anis-Syakira Jailani
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, Shah Alam, Selangor, 40170, Malaysia
| | - Nur Zahirah Balqis-Ali
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, Shah Alam, Selangor, 40170, Malaysia.
| | - Kar Foong Tang
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, Shah Alam, Selangor, 40170, Malaysia
| | - Weng Hong Fun
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, Shah Alam, Selangor, 40170, Malaysia
| | - Shazimah Abdul Samad
- Family Health Section, Family Health Development Division, Ministry of Health, Malaysia, Putrajaya, 62590, Malaysia
| | - Rohaidza Jahaya
- Family Health Section, Family Health Development Division, Ministry of Health, Malaysia, Putrajaya, 62590, Malaysia
| | - Nurun Najihah Subakir
- Family Health Section, Family Health Development Division, Ministry of Health, Malaysia, Putrajaya, 62590, Malaysia
| | - Roziah Ismail
- Family Health Section, Family Health Development Division, Ministry of Health, Malaysia, Putrajaya, 62590, Malaysia
| | - Zakiah Mohd Said
- Family Health Section, Family Health Development Division, Ministry of Health, Malaysia, Putrajaya, 62590, Malaysia
| | - Sondi Sararaks
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, Shah Alam, Selangor, 40170, Malaysia
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Buang SN, Ja'afar S, Pathmanathan I, Saint V. Human papillomavirus immunisation of adolescent girls: improving coverage through multisectoral collaboration in Malaysia. BMJ 2018; 363:k4602. [PMID: 30530626 PMCID: PMC6282734 DOI: 10.1136/bmj.k4602] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Saidatul Buang and colleagues report on collaborative efforts to introduce HPV vaccination in Malaysia and increase coverage
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Affiliation(s)
- Saidatul N Buang
- Family Health Development Division, Ministry of Health, Kuala Lumpur, Malaysia
| | - Safurah Ja'afar
- Department of Community Medicine, International Medical University, Kuala Lumpur, Malaysia
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Sainei NE, Kumar VS, Chin YS, Salih FAM. High Prevalence of Human Papillomavirus Types 56 and 70 Identified in the Native Populations of Sabah, Malaysia. Asian Pac J Cancer Prev 2018; 19:2807-2813. [PMID: 30360610 PMCID: PMC6291022 DOI: 10.22034/apjcp.2018.19.10.2807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Cervical cancer is currently the third most common female cancer in Malaysia, with the human papillomavirus (HPV) considered as one of the important contributory factors. This study was conducted to determine HPV prevalence, its genotype distribution, and other potential risk factors among women in Kota Kinabalu, Sabah in order to evaluate the likely efficacy of current HPV vaccines in the local population. Methods: A total of 240 cervical samples were collected and subjected to DNA extraction, PCR amplification using the MY09/MY11 primer pair, and restriction fragment length polymorphism (RFLP) for HPV detection and genotyping. Sociodemographic, clinical, and behavioural data were also collected via questionnaires. Results: The prevalence of HPV infection was 9.6%. The most common HPVs among 13 genotypes were high-risk HPV-56 (16.7%) and probable high-risk HPV-70 (16.7%) followed by HPV-16, -58, -53, -61, -33, -59, and -66 (in decreasing order of prevalence) including the rare genotypes: HPV-62, -81, -82 and -84. Statistical analyses using logistic regression models showed that HPV infection was significantly associated with employment (OR 4.94; CI 1.58-15.40) and education at secondary/high school level (OR 0.13; CI 0.03-0.62). Conclusion: Distribution of HPV genotypes in Sabah indicated a high prevalence of HPV-56 and -70 which are among the rare HPV types in West Malaysia and merit consideration in future strategies for HPV vaccination specifically for local Sabahan women.
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Affiliation(s)
- Nur Ezzah Sainei
- Department of Biomedical Sciences and Therapeutics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia.
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Tan SC, Ismail MP, Duski DR, Othman NH, Ankathil R. Prevalence and type distribution of human papillomavirus (HPV) in Malaysian women with and without cervical cancer: an updated estimate. Biosci Rep 2018; 38:BSR20171268. [PMID: 29487170 PMCID: PMC5874263 DOI: 10.1042/bsr20171268] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 02/23/2018] [Accepted: 02/27/2018] [Indexed: 11/30/2022] Open
Abstract
Information on the prevalence and type distribution of human papillomavirus (HPV) among Malaysian women is currently limited. The present study therefore aimed to provide an updated estimate on the prevalence and type distribution of HPV among Malaysian women with and without cervical cancer. Total DNA was isolated from the cervical cell specimens of 185 histopathologically confirmed cervical cancer patients and 209 cancer-free healthy females who were tested negative in a recent Pap test. Viral-specific DNA was subsequently amplified with biotinylated primers and hybridized to HPV type-specific probes via a proprietary "flow-through hybridization" process for determination of HPV genotype. It was demonstrated that 83.2% of the cervical cancer patients and none (0.0%) of the cancer-free females were positive for HPV infection. Among HPV-positive subjects, 14 different viral genotypes were observed, namely HPV16, 18, 31, 33, 35, 45, 52, 53, 58, 66/68, 73, 81, 82, and 84/26. A total of 91.6% of the HPV-positive subjects had single-type HPV infections and the remaining 8.4% were simultaneously infected by two HPV genotypes. The most common HPV infections found were HPV16 (35.7%), HPV18 (26.0%), HPV58 (9.1%), and HPV33 (7.1%) single-type infections, followed by HPV16 + HPV18 co-infections (5.2%). The study has successfully provided an updated estimate on the prevalence and type distribution of HPV among Malaysian women with and without cervical cancer. These findings could contribute valuable information for appraisal of the impact and cost-effectiveness of prophylactic HPV vaccines in the Malaysian population.
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Affiliation(s)
- Shing Cheng Tan
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Mohd Pazudin Ismail
- Department of Obstetrics and Gynecology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Daniel Roza Duski
- Department of Obstetrics and Gynecology, Hospital Sultan Ismail, 81100 Johor Bahru, Johor, Malaysia
| | - Nor Hayati Othman
- Department of Pathology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Ravindran Ankathil
- Human Genome Centre, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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Xu L, Xu J, Hu Z, Yang B, Wang L, Lin X, Xia Z, Zhang Z, Zhu Y. Quantitative DNA methylation analysis of paired box gene 1 and LIM homeobox transcription factor 1 α genes in cervical cancer. Oncol Lett 2018. [PMID: 29541217 DOI: 10.3892/ol.2018.7872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
DNA methylation is associated with tumorigenesis and may act as a potential biomarker for detecting cervical cancer. The aim of the present study was to explore the methylation status of the paired box gene 1 (PAX1) and the LIM homeobox transcription factor 1 α (LMX1A) gene in a spectrum of cervical lesions in an Eastern Chinese population. This single-center study involved 121 patients who were divided into normal cervix (NC; n=28), low-grade squamous intraepithelial lesion (LSIL; n=32), high-grade squamous intraepithelial lesion (HSIL; n=34) and cervical squamous cell carcinoma (CSCC; n=27) groups, according to biopsy results. Following extraction and modification of the DNA, quantitative assessment of the PAX1 and LMX1A genes in exfoliated cells was performed using pyrosequencing analysis. Receiver operating characteristic (ROC) curves were generated to calculate the sensitivity and specificity of each parameter and cut-off values of the percentage of methylation reference (PMR) for differentiation diagnosis. Analysis of variance was used to identify differences among groups. The PMR of the two genes was significantly higher in the HSIL and CSCC groups compared with that in the NC and LSIL groups (P<0.001). ROC curve analysis demonstrated that the sensitivity, specificity and accuracy for detection of CSCC were 0.790, 0.837 and 0.809, respectively, using PAX1; and 0.633, 0.357 and 0.893, respectively, using LMX1A. These results indicated that quantitative PAX1 methylation demonstrates potential for cervical cancer screening, while further investigation is required to determine the potential of LMX1A methylation.
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Affiliation(s)
- Ling Xu
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Jun Xu
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Zheng Hu
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Baohua Yang
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Lifeng Wang
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Xiao Lin
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Ziyin Xia
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Zhiling Zhang
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
| | - Yunheng Zhu
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai 201199, P.R. China
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Fehri E, Ennaifer E, Ardhaoui M, Ouerhani K, Laassili T, Bel Haj Rhouma R, Guizani I, Boubaker S. Expression of Toll-like receptor 9 increases with progression of cervical neoplasia in Tunisian women--a comparative analysis of condyloma, cervical intraepithelial neoplasia and invasive carcinoma. Asian Pac J Cancer Prev 2017; 15:6145-50. [PMID: 25124588 DOI: 10.7314/apjcp.2014.15.15.6145] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Toll-like receptors (TLRs) are expressed in immune and tumor cells and recognize pathogen-associated molecular patterns. Cervical cancer (CC) is directly linked to a persistent infection with high risk human papillomaviruses (HR-HPVs) and could be associated with alteration of TLRs expression. TLR9 plays a key role in the recognition of DNA viruses and better understanding of this signaling pathway in CC could lead to the development of novel immunotherapeutic approaches. The present study was undertaken to determine the level of TLR9 expression in cervical neoplasias from Tunisian women with 53 formalin-fixed and paraffin-embedded specimens, including 22 samples of invasive cervical carcinoma (ICC), 18 of cervical intraepithelial neoplasia (CIN), 7 of condyloma and 6 normal cervical tissues as control cases. Quantification of TLR9 expression was based on scoring four degrees of extent and intensity of immunostaining in squamous epithelial cells. TLR9 expression gradually increased from CIN1 (80% weak intensity) to CIN2 (83.3% moderate), CIN3 (57.1% strong) and ICC (100% very strong). It was absent in normal cervical tissue and weak in 71.4% of condyloma. The mean scores of TLR9 expression were compared using the Kruskall-Wallis test and there was a statistical significance between normal tissue and condyloma as well as between condyloma, CINs and ICC. These results suggest that TLR9 may play a role in progression of cervical neoplasia in Tunisian patients and could represent a useful biomarker for malignant transformation of cervical squamous cells.
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Affiliation(s)
- Emna Fehri
- HPV Unit Research. Laboratory of Molecular Epidemiology and Experimental Pathology Applied to Infectious Diseases, le Belvedere, Tunis, Tunisia E-mail :
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7
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Ahangar-Oskouee M, Shahmahmoodi S, Jalilvand S, Mahmoodi M, Ziaee AA, Esmaeili HA, Keshtvarz M, Pishraft-Sabet L, Yousefi M, Mollaei-Kandelous Y, Mokhtari-Azad T, Nategh R. No detection of 'high-risk' human papillomaviruses in a group of Iranian women with breast cancer. Asian Pac J Cancer Prev 2016; 15:4061-5. [PMID: 24935597 DOI: 10.7314/apjcp.2014.15.9.4061] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The presence of viral DNA in breast cancer cells is controversial. However, some studies have revealed a possible role for the human papillomavirus in the pathogenesis of breast cancer. The aim of the present study was to investigate the presence of HPV-DNA in breast tissue in a group of Iranian women with and without breast cancer and identification of the detected HPV types. Paraffin-embedded specimens from 65 malignant breast cancer cases and 65 cases with benign breast lesions were investigated for presence of HPV-DNA by nested polymerase chain reaction. We found HPV-DNA in 22 (33.8%) of the breast cancer specimens. All non-cancerous specimens were negative. Low and high-risk HPV types, including HPV-6 (26.2%), HPV-16 (1.5%), HPV-35 (1.5%), HPV-52 (1.5%), and HPV-11 (1.5%) were detected in our study. HPV-6 was the most prevalent type in the breast cancer specimens. Although high-risk HPV types have been shown to have a major role in cervix cancer, there have been no data that support the same relevance for other types of malignancies. Furthermore, presence of low-risk HPV types in malignancies still is a matter of debate. The data presented in this study indicates a strong need for epidemiological studies correlating different HPV types in human breast cancer.
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Affiliation(s)
- Mahin Ahangar-Oskouee
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran E-mail :
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Salcedo M, Pina-Sanchez P, Vallejo-Ruiz V, Monroy-Garcia A, Aguilar-Lemarroy A, Cortes-Gutierrez EI, Santos-Lopez G, Montoya-Fuentes H, Grijalva R, Madrid-Marina V, Apresa-Garcia T, Hernandez DM, Jave-Suarez LF, Romero P, Poot A, Salgado E, Ramos-Gonzalez P, Gonzalez-Hernandez R, Canton JC, Jimenez-Aranda L, Parra-Melquiadez M, Paniagua L, Mendoza M, Arreola H, Villegas V, Torres-Poveda K, Bahena-Roman M, Gonzalez-Yebra B, Taniguchi K, Rodea C, Mantilla-Morales A, Mora-Garcia ML, Velazquez-Velazquez CK, Cordova-Uscanga C, Peralta R, Lopez-Romero R, Marrero D, Bandala C, Reyes-Leyva J, Furuya ME, Almeida E, Galvan ME, Grijalva I. Human papillomavirus genotypes among females in Mexico: a study from the Mexican institute for social security. Asian Pac J Cancer Prev 2015; 15:10061-6. [PMID: 25556426 DOI: 10.7314/apjcp.2014.15.23.10061] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aetiological relationship between human papillomavirus (HPV) infection and cervical cancer (CC) is widely accepted. Our goal was to determine the prevalence of HPV types in Mexican women attending at the Mexican Institute for Social Security from different areas of Mexico. MATERIALS AND METHODS DNAs from 2,956 cervical samples were subjected to HPV genotyping: 1,020 samples with normal cytology, 931 with low-grade squamous intraepithelial lesions (LGSIL), 481 with high grade HGSIL and 524 CC. RESULTS Overall HPV prevalence was 67.1%. A total of 40 HPV types were found; HPV16 was detected in 39.4% of the HPV-positive samples followed by HPV18 at 7.5%, HPV31 at 7.1%, HPV59 at 4.9%, and HPV58 at 3.2%. HPV16 presented the highest prevalence both in women with altered or normal cytology and HPV 18 presented a minor prevalence as reported worldwide. The prevalence ratio (PR) was calculated for the HPV types. The analysis of PR showed that HPV16 presents the highest association with CC, HPV 31, -33, -45, -52 and -58 also demonstrating a high association. CONCLUSIONS The most prevalent HPV types in cervical cancer samples were -16, -18, -31, but it is important to note that we obtained a minor prevalence of HPV18 as reported worldwide, and that HPV58 and -52 also were genotypes with an important prevalence in CC samples. Determination of HPV genotypes is very important in order to evaluate the impact of vaccine introduction and future cervical cancer prevention strategies.
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Affiliation(s)
- Mauricio Salcedo
- Unidad de Investigacion Medica en Enfermedades Oncologicas, Hospital de Oncologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (Mexican Institute for Social Security; IMSS), Mexico E-mail :
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Othman NH, Mohamad Zaki FH. Self-collection tools for routine cervical cancer screening: a review. Asian Pac J Cancer Prev 2015; 15:8563-9. [PMID: 25374168 DOI: 10.7314/apjcp.2014.15.20.8563] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Sub-optimal participation is a major problem with cervical cancer screening in developing countries which have no organized national screening program. There are various notable factors such as 'embarrassment', 'discomfort' and 'no time' cited by women as they are often also the bread winners for the family. Implementation of self-sampling methods may increase their participation. The aim of this article was to provide a survey of various types of self-sampling tools which are commonly used in collection of cervical cells. We reviewed currently available self-sampling devices and collated the advantages and disadvantages of each in terms of its acceptance and its accuracy in giving desired results. In general, regardless of which device is used, self-sampling for cervical scrapings is highly acceptable to women in most of the studies cited.
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Affiliation(s)
- Nor Hayati Othman
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia E-mail :
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Moga MA, Irimie M, Oanta A, Pascu A, Burtea V. Type-specific prevalence of human papillomavirus by cervical cytology among women in Brasov, Romania. Asian Pac J Cancer Prev 2015; 15:6887-92. [PMID: 25169541 DOI: 10.7314/apjcp.2014.15.16.6887] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The oncogenic role of human papillomavirus (HPV) in triggering cervical cancer, the second most common cancer in women worldwide, is well established. Romania ranks in first place in Europe in terms of the incidence of cervical cancer. Geographical widespread data on HPV type-distribution are essential for estimating the impact of HPV vaccines and cervical cancer screening programmes. In this study we aimed to identify the prevalence of HPV genotypes and to establish correlations with abnormal cervical cytology among the female population of Brasov County, Romania. A total of 1,000 women aged 17.3-57 years, attending routine cervical examination in the Obstetrics and Gynecology Hospital of Brasov, Romania, and undergoing both cytological examination and HPV genotyping were screened. Infection with 35 different HPV genotypes was detected in 39.6% of cytological specimens. Overall HPV infections were highest in young women under 25 years (p<0.0001), in which cervical cytological abnormalities also reached the highest prevalence. Patients infected by HPV-16 or HPV-18 showed the highest prevalence of cervical cytological abnormalities. Some 48.2% of women with abnormal cytology were infected with high-risk HPV types whereas less than 3% of them were infected only with low-risk HPV types. Our study showed that the prevalence of high-risk HPV infection among Romanian women is higher compared to other studies in other geographic areas. Thus, we consider that in areas where there is an increased prevalence of high-risk HPV infections, HPV genotyping should be performed in all women aged between 18 and 45 years, and Pap test should be performed every 6 months in women with high-risk HPV infection, even those with previous normal cervical cytology.
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Siriaunkgul S, Settakorn J, Sukpan K, Srisomboon J, Suprasert P, Kasatpibal N, Khunamornpong S. Population-based cervical cancer screening using high-risk HPV DNA test and liquid-based cytology in northern Thailand. Asian Pac J Cancer Prev 2015; 15:6837-42. [PMID: 25169534 DOI: 10.7314/apjcp.2014.15.16.6837] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Northern Thailand is a region with a high cervical cancer incidence. Combined high-risk HPV (hrHPV) DNA testing and cytology (co-testing) has increasingly gained acceptance for cervical cancer screening. However, to our knowledge, data from a population-based screening using co-testing have not been available in this region. This study therefore aimed to evaluate the performance of cytology and hrHPV test in women in northern Thailand. MATERIALS AND METHODS Cervical samples were collected for hybrid capture 2 (HC2) testing and liquid-based cytology from women aged 30 to 60 years who were residents in 3 prefectures of Chiang Mai in northern Thailand between May and September 2011. Women with positive cytology were referred to colposcopy, while women with positive for HC2 only were followed for 2 years. RESULTS Of 2,752 women included in this study, 3.0% were positive in both tests, 4.1% for HC2 only, and 1.3% had positive cytology only. At baseline screening, positive HC2 was observed in 70.6% among cytology-positive women compared with 4.3% among cytology-negative women. The prevalence of positive HC2 or cytology peaked in the age group 35-39 years and was lowest in the age group 55-60 years. High-grade squamous intraepithelial lesion or worse lesions (HSIL+) were histologically detected in 23.5% of women with positive baseline cytology and in 9.8% of women with positive baseline HC2 only on follow-up. All women with histologic HSIL+ had positive baseline HC2. CONCLUSIONS The hrHPV test is superior to cytology in the early detection of high-grade cervical epithelial lesions. In this study, the prevalence of histologic HSIL+ on follow-up of women with positive hrHPV test was rather high, and these women should be kept under careful surveillance. In northern Thailand, hrHPV testing has a potential to be used as a primary screening test for cervical cancer with cytology applied as a triage test.
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Affiliation(s)
- Sumalee Siriaunkgul
- Department of Pathology, Faculty of Medicine, 3Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand E-mail :
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Nalliah S, Karikalan B, Kademane K. Multifaceted Usage of HPV Related Tests and Products in the Management of Cervical Cancer - a Review. Asian Pac J Cancer Prev 2015; 16:2145-50. [DOI: 10.7314/apjcp.2015.16.6.2145] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bansal D, Elmi AA, Skariah S, Haddad P, Abu-Raddad LJ, Al Hamadi AH, Mohamed-Nady N, Affifi NM, Ghedira R, Hassen E, Al-Thani AAJ, Al-Ansari AAHM, Sultan AA. Molecular epidemiology and genotype distribution of Human Papillomavirus (HPV) among Arab women in the State of Qatar. J Transl Med 2014; 12:300. [PMID: 25424736 PMCID: PMC4251937 DOI: 10.1186/s12967-014-0300-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 10/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human Papilloma Virus (HPV) infection is the major cause of cervical cancer worldwide. With limited data available on HPV prevalence in the Arab countries, this study aimed to identify the prevalence and genotypic distribution of HPV in the State of Qatar. METHODS 3008 cervical samples, exclusively of women with Arabic origin residing in Qatar were collected from the Women's Hospital and Primary Health Care Corporation in Doha, State of Qatar. HPV DNA detection was done using GP5+/6+ primers based real time-polymerase chain reaction (RT-PCR) assay followed by the usage of HPV type specific primers based RT- PCR reactions and Sanger sequencing for genotype identification. RESULTS Similar prevalence rates of HPV infection was identified in both Qatari and non-Qatari women at 6.2% and 5.9% respectively. HPV prevalence rate of 5.8% and 18.4% was identified in women with normal cytology and in women with abnormal cytology respectively. HPV 81, 11 and 16, in decreasing order were the most commonly identified genotypes. HPV 81 was the most frequent low-risk genotype among women with both normal (74.0%) and abnormal (33.3%) cytology. HPV 16 (4.6%) was identified as the predominant high-risk HPV genotype among women with normal cytology and HPV 16, HPV 18, and HPV 56 (22.2% each) were the most common identified high-risk genotypes in women with abnormal cytology. CONCLUSIONS The overall HPV prevalence in Arab women in Qatar was identified as 6.1% with an increased HPV prevalence seen in women with abnormal cytology results and no significant trends seen with age. In contrast to Western countries, we report a varied genotypic profile of HPV with a high prevalence of low-risk HPV genotype 81 among the Arab women residing in Qatar.
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Affiliation(s)
- Devendra Bansal
- Department of Microbiology and Immunology, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | - Asha A Elmi
- Department of Microbiology and Immunology, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | - Sini Skariah
- Department of Microbiology and Immunology, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | - Pascale Haddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | - Aysha H Al Hamadi
- Department of laboratory Medicine and Pathology, Cytopathology, Hamad Medical Corporation, Doha, Qatar.
| | - Nady Mohamed-Nady
- Department of Obstetrics & Gynecology, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
| | | | - Randa Ghedira
- Laboratoire d'Immuno-Oncologie Moléculaire Faculté de Médecine de Monastir, 5019, Monastir, Tunisia.
| | - Elham Hassen
- Laboratoire d'Immuno-Oncologie Moléculaire Faculté de Médecine de Monastir, 5019, Monastir, Tunisia.
| | - Asma A J Al-Thani
- Health Sciences Department, Biomedical Sciences Program, University of Qatar, Doha, Qatar.
| | | | - Ali A Sultan
- Department of Microbiology and Immunology, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
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Sohrabi A, Mirab-Samiee S, Rahnamaye-Farzami M, Rafizadeh M, Akhavan S, Hashemi-Bahremani M, Modarressi MH. C13orf18 and C1orf166 (MULAN) DNA Genes Methylation are Not Associated with Cervical Cancer and Precancerous Lesions of Human Papillomavirus Genotypes in Iranian Women. Asian Pac J Cancer Prev 2014; 15:6745-8. [DOI: 10.7314/apjcp.2014.15.16.6745] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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15
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Sohrabi A, Mirab-Samiee S, Modarressi MH, Izadimood N, Azadmanesh K, Rahnamaye-Farzami M. Development of In-House Multiplex Real Time PCR for Human Papillomavirus Genotyping in Iranian Women with Cervical Cancer and Cervical Intraepithelial Neoplasia. Asian Pac J Cancer Prev 2014; 15:6257-61. [DOI: 10.7314/apjcp.2014.15.15.6257] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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