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Clarke MA, Wentzensen N, Perkins RB, Garcia F, Arrindell D, Chelmow D, Cheung LC, Darragh TM, Egemen D, Guido R, Huh W, Locke A, Lorey TS, Nayar R, Risley C, Saslow D, Smith RA, Unger ER, Massad LS. Recommendations for Use of p16/Ki67 Dual Stain for Management of Individuals Testing Positive for Human Papillomavirus. J Low Genit Tract Dis 2024; 28:124-130. [PMID: 38446575 DOI: 10.1097/lgt.0000000000000802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
OBJECTIVES The Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee developed recommendations for dual stain (DS) testing with CINtec PLUS Cytology for use of DS to triage high-risk human papillomavirus (HPV)-positive results. METHODS Risks of cervical intraepithelial neoplasia grade 3 or worse were calculated according to DS results among individuals testing HPV-positive using data from the Kaiser Permanente Northern California cohort and the STudying Risk to Improve DisparitiES study in Mississippi. Management recommendations were based on clinical action thresholds developed for the 2019 American Society for Colposcopy and Cervical Pathology Risk-Based Management Consensus Guidelines. Resource usage metrics were calculated to support decision-making. Risk estimates in relation to clinical action thresholds were reviewed and used as the basis for draft recommendations. After an open comment period, recommendations were finalized and ratified through a vote by the Consensus Stakeholder Group. RESULTS For triage of positive HPV results from screening with primary HPV testing (with or without genotyping) or with cytology cotesting, colposcopy is recommended for individuals testing DS-positive. One-year follow-up with HPV-based testing is recommended for individuals testing DS-negative, except for HPV16- and HPV18-positive results, or high-grade cytology in cotesting, where immediate colposcopy referral is recommended. Risk estimates were similar between the Kaiser Permanente Northern California and STudying Risk to Improve DisparitiES populations. In general, resource usage metrics suggest that compared with cytology, DS requires fewer colposcopies and detects cervical intraepithelial neoplasia grade 3 or worse earlier. CONCLUSIONS Dual stain testing with CINtec PLUS Cytology is acceptable for triage of HPV-positive test results. Risk estimates are portable across different populations.
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Affiliation(s)
- Megan A Clarke
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD
| | - Rebecca B Perkins
- Department of Obstetrics and Gynecology, Boston University School of Medicine/Boston Medical Center, Boston, MA
| | | | | | - David Chelmow
- Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Li C Cheung
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD
| | - Teresa M Darragh
- The Department of Pathology, University of California, San Francisco, CA
| | - Didem Egemen
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD
| | - Richard Guido
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Magee-Womens Hospital, Pittsburgh, PA
| | - Warner Huh
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL
| | - Alexander Locke
- Department of Obstetrics and Gynecology (Retired), The Permanente Medical Group, Oakland, CA
| | - Thomas S Lorey
- Regional Laboratory, Kaiser Permanente Northern California, Oakland, CA
| | - Ritu Nayar
- Department of Pathology, Northwestern University Feinberg School of Medicine and Northwestern Medical Group, Chicago, IL
| | | | - Debbie Saslow
- Prevention and Early Detection Department, American Cancer Society, Atlanta, GA
| | - Robert A Smith
- Early Cancer Detection Science, American Cancer Society, Atlanta, GA
| | - Elizabeth R Unger
- Chronic Viral Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA
| | - L Stewart Massad
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO
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Reaves S, Hall KC, Stewart MW, Wentzensen N, Ferrell C, Risley C, Wells J, Rives R, Bobo F, Daniels J, Farrington K, Morgan JC, Clarke MA. Evaluation of Follow-up Colposcopy Procedures After Abnormal Cervical Screening Result Across a Statewide Study in Mississippi. Res Sq 2024:rs.3.rs-3943646. [PMID: 38410464 PMCID: PMC10896379 DOI: 10.21203/rs.3.rs-3943646/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Purpose Cervical screening is used to detect and treat precancers to prevent invasive cancers. However, successful prevention also requires adequate follow-up and treatment of individuals with abnormal screening results. The aim was to investigate demographics, clinical characteristics, and follow-up status for individuals needing colposcopy after an abnormal screening result. Methods The STRIDES (Studying Risk to Improve DisparitiES) cohort comprises individuals undergoing cervical cancer screening and management at a Mississippi Health Department or University of Mississippi clinic. Follow-up status, demographics, and clinical data were assessed from electronic health records and, if necessary, patient navigation on individuals identified as needing a colposcopy after an abnormal screening. Results Of the 1,458 individuals requiring colposcopy, 43.0% had the procedure within 4 months, 16.4% had a delayed procedure, and 39.5% had no documented follow-up, with significant predictors of follow-up identified as age and cytology diagnosis. Based on age, individuals 30 + were more likely to follow up with a colposcopy compared to individuals < 30 years (49% and 38.7%, respectively; p < .001). Individuals with cytology diagnoses of LSIL (52.9%), ASC-H (51.4%), and HSIL (62.3%) had higher percentages of adherence to follow-up colposcopy guidelines (p < .001). Conclusion Despite high cervical cancer screening rates among Mississippians, a substantial portion did not have adequate next-step intervention. However, it is encouraging that highest risk individuals were more likely to have a colposcopy. Regardless, continuing to understand the underlying causes for incomplete follow-up is crucial for timely secondary targeted interventions to reduce cervical cancer burden, promote awareness, and improve health outcomes.
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Affiliation(s)
- Sydney Reaves
- University of Mississippi Medical Center, School of Nursing
| | | | | | | | | | - Carolann Risley
- University of Mississippi Medical Center, Cancer Research Institute
| | - Jimmie Wells
- University of Mississippi Medical Center, School of Nursing
| | - Rhonda Rives
- Mississippi Baptist Medical Center, Department of Pathology
| | - Fajada Bobo
- University of Mississippi Medical Center, Department of Pathology
| | | | | | - Jody C Morgan
- University of Mississippi Medical Center, School of Medicine
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Risley C, Douglas K, Karimi M, Brumfield J, Gartrell G, Vargas R, Zhang L. Trends in Sexual Risk Behavioral Responses among High School Students between Mississippi and the United States: 2001 to 2019 YRBSS. J Sch Health 2023; 93:500-507. [PMID: 36973577 DOI: 10.1111/josh.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/11/2022] [Accepted: 02/05/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Early sexual reproductive health (SRH) education is linked to a reduction in risky sexual behaviors. Sexually transmitted infections (STIs) are rising at alarming rates. Risky sexual behaviors, including initiation of sex before age 13, having more than four sexual partners, and lack of use of condoms, increase the chance of infection and cancer. Informing students about the link between risky behaviors and cancer is vital to reduce morbidity and mortality. METHODS A trend analysis of the Youth Risk Behavior Surveillance System (YRBSS) data between 2001 and 2019 was conducted. Results from four survey responses related to sexual risk behaviors among 9th to 12th grade in Mississippi students are compared with their US peers. RESULTS Between 2001 and 2019, favorable declines in 3 out of 4 sexual risk behaviors were observed. Declining prevalence was reported for "ever had sexual intercourse," "age of sexual initiation at age 13 or younger," and "having 4 or more sexual partners in their lifetime" are promising. However, fewer students report using condoms. The adjusted prevalence rates for Mississippi students in all 4 measures were higher than the national responses. CONCLUSIONS Our analysis supports the need for early skill-based sex education to promote health. States with increased behavioral risk among students should consider trends in data to improve education and policy.
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Affiliation(s)
- Carolann Risley
- University of Mississippi Medical Center, School of Nursing,| School of Medicine, Department of Cell and Molecular Biology, Cancer Center and Research Institute, Jackson, MS, United States
| | - Kimberly Douglas
- University of Mississippi Medical Center, School of Nursing, Jackson, MS
| | - Masoumeh Karimi
- University of Mississippi Medical Center, School of Nursing, Jackson, MS
| | - Jennifer Brumfield
- University of Mississippi Medical Center, School of Graduate Studies in Health Sciences, Jackson, MS, United States
| | - Gordon Gartrell
- University of Mississippi Medical Center, School of Graduate Studies in Health Sciences, Jackson, MS, United States
| | - Rodolfo Vargas
- Office of Health Data and Research, Mississippi State Department of Health, Jackson, MS, United States
| | - Lei Zhang
- University of Mississippi Medical Center, School of Nursing,| Professor, Data Science, John D. Bower School of Population Health,| Professor, Health Administration, School of Health Related Professions, Jackson, MS, United States
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Takeda K, Risley C, Kousar A, Briley KP, Prenshaw K, Talluri R, Geisinger KR, Rebellato LM. Post‐kidney transplant cancers: Racial and ethnic differences in sun‐exposed skin versus non‐sun‐exposed anogenital skin. Cancer Med 2022; 12:7348-7355. [PMID: 36373513 PMCID: PMC10067113 DOI: 10.1002/cam4.5431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Transplant recipients have a 2- to 4-fold increased risk of developing malignancies over the general population. Cancer is the second most common cause of death for recipients. The magnitude of the risk depends on the cancer type and increases in viral-related malignancies. Skin cancer is the most common. However, data in most cancer registries is limited to cutaneous melanomas, thereby limiting the epidemiologic examination of cancer risk in non-melanoma skin cancer. Our goal was to evaluate post-kidney transplant cancer cases and sites in our population to guide screening recommendations. METHODS Between 2009 and 2015, a retrospective study of adult kidney recipients transplanted at East Carolina University was conducted. The first cancer diagnosis after transplant through February 18, 2020, was captured and analyzed. Patient demographics, cancer sites, and histological diagnoses were analyzed and compared. p16 immunohistochemistry was used as a surrogate marker for high-risk human papillomavirus (HPV) infection. RESULTS Retrospectively, kidney transplant recipients were analyzed (N = 439), the majority were non-Hispanic Black (NHB) individuals, 312 (71.1%), and 127 (28.9%) were non-Hispanic White (NHW) individuals. Of these, 59 (13.4%) developed a posttransplant malignancy, with the majority on sun-exposed skin found in NHW. NHB had all anogenital/mucosa skin cancers on non-sun-exposed skin. Of these detected in NHB, all were squamous cell carcinomas, with five out of six (83.3%) being positive for p16. CONCLUSIONS Posttransplant malignancy differed significantly by race, site, and potential source of etiology. The majority of malignancies are likely explained by acceleration of precursor lesions from prior exposure to ultraviolet rays or HPV.
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Affiliation(s)
- Kotaro Takeda
- Department of Pathology and Laboratory Medicine, Brody School of Medicine East Carolina University and Vidant Medical Center Greenville North Carolina USA
| | - Carolann Risley
- Department of Cell and Molecular Biology, and Cancer Center and Research Institute University of Mississippi Medical Center, School of Nursing, School of Medicine Jackson Mississippi USA
| | - Aisha Kousar
- Department of Pathology and Laboratory Medicine, Brody School of Medicine East Carolina University and Vidant Medical Center Greenville North Carolina USA
| | - Kimberly P. Briley
- Department of Pathology and Laboratory Medicine, Brody School of Medicine East Carolina University and Vidant Medical Center Greenville North Carolina USA
| | - Karyn Prenshaw
- Department of Pathology and Laboratory Medicine, Brody School of Medicine East Carolina University and Vidant Medical Center Greenville North Carolina USA
| | - Rajesh Talluri
- Department of Data Science, School of Population Health University of Mississippi Medical Center Jackson Mississippi USA
| | - Kim R. Geisinger
- Walter Reed Military Medical Center The Joint Pathology Center Silver Springs Maryland USA
| | - Lorita M. Rebellato
- Department of Pathology and Laboratory Medicine, Brody School of Medicine East Carolina University and Vidant Medical Center Greenville North Carolina USA
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Risley C, Stewart MW, Geisinger KR, Hiser LM, Morgan JC, Owens KJ, Ayyalasomayajula K, Rives RM, Jannela A, Grunes DE, Zhang L, Schiffman M, Wentzensen N, Clarke MA. STRIDES - STudying Risk to Improve DisparitiES in Cervical Cancer in Mississippi - Design and baseline results of a Statewide Cohort Study. Prev Med 2021; 153:106740. [PMID: 34293382 PMCID: PMC8595817 DOI: 10.1016/j.ypmed.2021.106740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/21/2021] [Accepted: 07/17/2021] [Indexed: 12/13/2022]
Abstract
Cervical cancer rates in Mississippi are disproportionately high, particularly among Black individuals; yet, research in this population is lacking. We designed a statewide, racially diverse cohort of individuals undergoing cervical screening in Mississippi. Here, we report the baseline findings from this study. We included individuals aged 21 years and older undergoing cervical screening with cytology or cytology-human papillomavirus (HPV) co-testing at the Mississippi State Health Department (MSDH) and the University of Mississippi Medical Center (UMMC) (December 2017-May 2020). We collected discarded cytology specimens for future biomarker testing. Demographics and clinical results were abstracted from electronic medical records and evaluated using descriptive statistics and chi-square tests. A total of 24,796 individuals were included, with a median age of 34.8 years. The distribution of race in our cohort was 60.2% Black, 26.4% White, 7.5% other, and 5.9% missing. Approximately 15% had abnormal cytology and, among those who underwent co-testing at MSDH (n = 6,377), HPV positivity was 17.4% and did not vary significantly by race. Among HPV positives, Black individuals were significantly less likely to be HPV16/18 positive and more likely to be positive for other high-risk 12 HPV types compared to White individuals (20.5% vs. 27.9%, and 79.5% and 72.1%, respectively, p = 0.011). Our statewide cohort represents one of the largest racially diverse studies of cervical screening in the U.S. We show a high burden of abnormal cytology and HPV positivity, with significant racial differences in HPV genotype prevalence. Future studies will evaluate cervical precancer risk, HPV genotyping, and novel biomarkers in this population.
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Affiliation(s)
- Carolann Risley
- National Cancer Institute, Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, Rockville, MD, United States of America; University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America; University of Mississippi Medical Center, Department of Cell and Molecular Biology, Jackson, MS, United States of America.
| | - Mary W Stewart
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America.
| | - Kim R Geisinger
- Joint Pathology Center, Walter Reed National Military Medical Center, Silver Spring, MD, United States of America; East Carolina University, Department of Pathology, Greenville, NC, United States of America.
| | - Laree M Hiser
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America.
| | - Jody C Morgan
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America.
| | - Kenyata J Owens
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America; University of Mississippi Medical Center, Center for Informatics & Analytics, Jackson, MS, United States of America.
| | - Krishna Ayyalasomayajula
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America; University of Mississippi Medical Center, Center for Informatics & Analytics, Jackson, MS, United States of America.
| | - Rhonda M Rives
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America; University of Mississippi Medical Center, Department of Pathology, Jackson, MS, United States of America..
| | - Ashish Jannela
- University of Mississippi Medical Center, Center for Informatics & Analytics, Jackson, MS, United States of America.
| | - Dianne E Grunes
- University of Mississippi Medical Center, Department of Pathology, Jackson, MS, United States of America..
| | - Lei Zhang
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America; Mississippi State Department of Health, Research & Statistics, Jackson, MS, United States of America.
| | - Mark Schiffman
- National Cancer Institute, Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, Rockville, MD, United States of America.
| | - Nicolas Wentzensen
- National Cancer Institute, Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, Rockville, MD, United States of America.
| | - Megan A Clarke
- National Cancer Institute, Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, Rockville, MD, United States of America.
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6
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Clarke MA, Risley C, Stewart MW, Geisinger KR, Hiser LM, Morgan JC, Owens KJ, Ayyalasomayajula K, Rives RM, Jannela A, Grunes DE, Zhang L, Schiffman M, Wagner S, Boland J, Bass S, Wentzensen N. Age-specific prevalence of human papillomavirus and abnormal cytology at baseline in a diverse statewide prospective cohort of individuals undergoing cervical cancer screening in Mississippi. Cancer Med 2021; 10:8641-8650. [PMID: 34734483 PMCID: PMC8633239 DOI: 10.1002/cam4.4340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 12/22/2022] Open
Abstract
Background Mississippi (MS) has among the highest rates of cervical cancer incidence and mortality in the United States, with disproportionately higher rates among Blacks compared to Whites. Here, we evaluate the prevalence of high‐risk human papillomavirus (HPV) and abnormal cytology in a representative baseline sample from a diverse statewide cohort of individuals attending cervical screening in MS from the STRIDES Study (STudying Risk to Improve DisparitiES in cervical cancer). Methods We included individuals aged 21–65 years undergoing screening at the University of Mississippi Medical Center (UMMC) and the Mississippi State Department of Health (MSDH) from May to November 2018. We calculated age‐specific HPV prevalence, overall and by partial HPV16/18 genotyping, and abnormal cytology by race. Results A total of 6871 individuals (mean age 35.7 years) were included. HPV prevalence was 25.6% and higher in Blacks (28.0%) compared to Whites (22.4%). HPV prevalence was significantly higher in Blacks aged 21–24 years (50.2%) and 30–34 years (30.2%) compared to Whites in the same age groups (32.1% and 20.7%; p < 0.0001, respectively). The prevalence of high‐grade cytologic abnormalities, a cytologic sign of cervical precancer, peaked earlier in Blacks (ages 25–29) compared to Whites (35–39). For comparison, we also analyzed HPV prevalence data from the National Health and Nutrition Examination Survey (NHANES, 2013–2016) and observed similar racial differences in HPV prevalence among women aged 21–24 years. Conclusions Our findings suggest that Blacks undergoing cervical cancer screening in MS have higher prevalence of other high‐risk 12 HPV types at younger ages and experience an earlier peak of high‐grade cytologic abnormalities compared to Whites.
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Affiliation(s)
- Megan A Clarke
- Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Carolann Risley
- Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA.,School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Mary W Stewart
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Kim R Geisinger
- Walter Reed National Military Medical Center, Armed Forces Joint Pathology Center, Bethesda, Maryland, USA
| | - Laree M Hiser
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jody C Morgan
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Kenyata J Owens
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Center for Informatics & Analytics, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Krishna Ayyalasomayajula
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Center for Informatics & Analytics, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Rhonda M Rives
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ashish Jannela
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Center for Informatics & Analytics, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Dianne E Grunes
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Lei Zhang
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Office of Health Data & Research, Mississippi State Department of Health, Jackson, Mississippi, USA
| | - Mark Schiffman
- Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Sarah Wagner
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland, USA
| | - Joseph Boland
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland, USA
| | - Sara Bass
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland, USA
| | - Nicolas Wentzensen
- Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA
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7
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Risley C, Clarke MA, Geisinger KR, Stewart MW, Zhang L, Hoover KW, Hiser LM, Owens K, DeMarco M, Schiffman M, Wentzensen N. Racial differences in HPV type 16 prevalence in women with ASCUS of the uterine cervix. Cancer Cytopathol 2020; 128:528-534. [PMID: 32243726 DOI: 10.1002/cncy.22267] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/16/2020] [Accepted: 03/09/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Understanding racial influences on human papillomavirus (HPV) distribution in women with atypical squamous cells of undetermined significance (ASCUS) cytology via partial genotyping in a statewide population can inform HPV-based prevention efforts. METHODS Women aged 21 to 65 years with any cytology result and partial HPV genotyping for ASCUS triage between January 1, 2014, and December 31, 2017, were included. All women attended a Mississippi State Department of Health clinic. Age, race, cytopathologic, and HPV data were extracted from the electronic health record and analyzed. Cytologic specimens were processed with ThinPrep and HPV testing with the Cobas 4800 assay. HPV genotypes were evaluated in hierarchical categories. Chi-square tests and multinomial logistic regression models evaluated associations between race and type prevalence. RESULTS There were 43,106 women who underwent cervical cancer screening with cytology and ASCUS triage. Of these, 34,363 (80.2%) had normal cytology, 4672 (10.9%) had ASCUS, 2683 (6.3%) had a low-grade squamous intraepithelial lesion, and 633 (1.5%) had a high-grade squamous intraepithelial lesion. Blacks represented 69.3% of the sample and had a higher proportion of HPV-positive ASCUS (6.5%) in comparison with whites (5.6%). Blacks had significantly decreased odds of HPV-16 (odds ratio [OR], 0.66; 95% confidence interval [CI], 0.6-0.9; P = .002) and significantly increased odds for 12 other types (OR, 1.37; 95% CI, 1.2-1.5; P < .0001) in comparison with whites. CONCLUSIONS In a diverse population, significant differences in HPV genotypes are shown by race. Importantly, blacks with ASCUS are less likely to be positive for HPV-16 in comparison with whites. Ongoing work is evaluating the individual genotype prevalence and genotype-specific risk of precancer by race.
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Affiliation(s)
- Carolann Risley
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi.,National Cancer Institute, Rockville, Maryland
| | | | - Kim R Geisinger
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi
| | - Mary W Stewart
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi
| | - Lei Zhang
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi.,Mississippi State Department of Health, Jackson, Mississippi
| | - Kim W Hoover
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi
| | - Laree M Hiser
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi
| | - Kenyata Owens
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi.,Center for Informatics and Analytics, University of Mississippi Medical Center, Jackson, Mississippi
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Risley C, Geisinger KR, Robinson JC, Stewart MW, Zhang L, Alexander R, Raab SS. Corrigendum to "Precancerous cervical lesions and HPV genotypes identified in previously unsatisfactory cervical smear tests after inexpensive glacial acetic acid processing" [Int J Gynecol Obstet 2018. doi: 10.1002/ijgo.12699.]. Int J Gynaecol Obstet 2019; 144:238. [PMID: 30609041 DOI: 10.1002/ijgo.12710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Carolann Risley
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
| | - Kim R Geisinger
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
| | - Jennifer C Robinson
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
| | - Mary W Stewart
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
| | - Lei Zhang
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA.,Mississippi State Department of Health, Jackson, MI, USA
| | - Rhonda Alexander
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
| | - Stephen S Raab
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
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9
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Risley C, Geisinger KR, Robinson JC, Stewart MW, Zhang L, Alexander R, Raab SS. Precancerous cervical lesions and HPV genotypes identified in previously unsatisfactory cervical smear tests after inexpensive glacial acetic acid processing. Int J Gynaecol Obstet 2018; 144:85-89. [PMID: 30362108 DOI: 10.1002/ijgo.12699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/21/2018] [Accepted: 10/23/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine the effectiveness of using glacial acetic acid (GAA) to convert unsatisfactory bloody ThinPrep (TP) cervical smear test to satisfactory, and identify associated missed diagnoses and high-risk HPV (hrHPV) genotypes. METHODS In a retrospective descriptive cross-sectional analysis, all TP tests performed in Mississippi, USA, 2012-2016, were evaluated for unsatisfactory results owing to blood. Tests that were converted to satisfactory by GAA treatment, and corresponding anomalies and HPV genotypes were identified. RESULTS Among 106 384 TP tests, there were 1460 (1.37%) unsatisfactory results, of which 1442 (98.77%) were converted to satisfactory after GAA treatment. Laboratory preprocessing with GAA increased costs minimally. Precancerous lesions were detected in 166 (11.51%) of 1442 GAA-treated samples, of which 12 (7.2%) were high-grade lesions, 110 (66.3%) were atypical squamous cells of undetermined significance, and 63 (57.3%) tested positive for hrHPV. Of 60 genotyped samples, 39 (65%) had non-HPV16 and non-HPV18. Including mixed infections, 48 (80%) contained less-common hrHPV types, reflecting an unexpected distribution in bloody specimens. CONCLUSIONS GAA pretreatment of bloody TP tests would reduce the incidence of unsatisfactory results and missed high-grade lesions, and prevent the cost of repeat tests and delayed treatment. Clinicians without access to GAA should consider HPV testing.
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Affiliation(s)
- Carolann Risley
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
| | - Kim R Geisinger
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
| | - Jennifer C Robinson
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
| | - Mary W Stewart
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
| | - Lei Zhang
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA.,Mississippi State Department of Health, Jackson, MI, USA
| | - Rhonda Alexander
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
| | - Stephen S Raab
- School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA
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Macdonald SJ, Belton DJ, Buckley DM, Spooner JE, Anson MS, Harrison LA, Mills K, Upton RJ, Dowle MD, Smith RA, Molloy CR, Risley C. Syntheses of trans-5-oxo-hexahydro-pyrrolo[3,2-b]pyrroles and trans-5-oxo-hexahydro-furo[3,2-b]pyrroles (pyrrolidine trans-lactams and trans-lactones): new pharmacophores for elastase inhibition. J Med Chem 1998; 41:3919-22. [PMID: 9767628 DOI: 10.1021/jm981026s] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S J Macdonald
- Enzyme Chemistry 2, Development Chemistry 3, Physical Sciences, and Enzyme Pharmacology, GlaxoWellcome Medicines Research Centre, Gunnels Wood Road, Stevenage SG1 2NY, U.K
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Kornegay E, Zhou W, Swinkels J, Risley C. Characterization of cobalt-copper antagonism
in the study of copper-stimulated growth
in weanling pigs. J Anim Feed Sci 1995. [DOI: 10.22358/jafs/69771/1995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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