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Marshall CA, Curran MA, Trejo J, Gonzalez AA, Armin J, Hamann HA, Badger TA, Garcia FAR. The Evolution of Un Abrazo Para La Familia: Implications for Survivors of Cancer. J Cancer Educ 2021; 36:1075-1080. [PMID: 32239477 DOI: 10.1007/s13187-020-01737-x] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Un Abrazo Para La Familia™ (Abrazo) is a 3-h modular preventive intervention designed for low-income caregivers who are co-survivors of cancer. Here we (1) consider the benefit to survivors of cancer, that is, the care recipients who participate in Abrazo; (2) summarize the literature specific to research outreach to low-income, underserved populations when they are faced with cancer; and (3) describe current steps being taken in Southern Arizona to reach these populations via Abrazo. Specific to considering the benefit to care recipients, we analyzed care recipient data derived from three existing cohorts of Abrazo participants. Analyses of the combined cohorts of these data demonstrate that Abrazo is effective with care recipients given statistically significant higher cancer knowledge and self-efficacy scores, pre- vs. post-intervention. We can now report benefit to care recipients who participate in Abrazo. This allows us, with confidence, to expand research recruitment efforts to include care recipients as part of the Abrazo intervention in our efforts to serve low-income, underserved populations when faced with cancer.
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Affiliation(s)
- Catherine A Marshall
- Department of Disability and Psychoeducational Studies, The University of Arizona, Tucson, AZ, USA.
| | - Melissa A Curran
- Department of Family Studies and Human Development, Tucson, AZ, USA
| | - Juanita Trejo
- Un Abrazo Para La Familia, The University of Arizona, Tucson, AZ, USA
- Department of Psychology, The University of Arizona, Tucson, AZ, USA
| | - Alma A Gonzalez
- Department of Disability and Psychoeducational Studies, The University of Arizona, Tucson, AZ, USA
- Un Abrazo Para La Familia, The University of Arizona, Tucson, AZ, USA
| | - Julie Armin
- Department of Family and Community Medicine, The University of Arizona, Tucson, AZ, USA
| | - Heidi A Hamann
- Department of Psychology, The University of Arizona, Tucson, AZ, USA
| | - Terry A Badger
- Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, AZ, USA
- Department of Psychiatry, The University of Arizona, Tucson, AZ, USA
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Wilkinson-Lee AM, Armenta AM, Leybas Nuño V, Moore-Monroy M, Hopkins A, Garcia FAR. Engaging promotora-led community-based participatory research: An introduction to a crossover design focusing on reproductive and mental health needs of a Latina community. ACTA ACUST UNITED AC 2018. [DOI: 10.1037/lat0000119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Affiliation(s)
- Lee A Learman
- Division of Obstetrics and Gynecology, Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
| | - Francisco A R Garcia
- Pima County, Tucson, Arizona
- College of Public Health, University of Arizona, Tucson
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Garcia FAR, Cornelison T, Nuño T, Greenspan DL, Byron JW, Hsu CH, Alberts DS, Chow HHS. Results of a phase II randomized, double-blind, placebo-controlled trial of Polyphenon E in women with persistent high-risk HPV infection and low-grade cervical intraepithelial neoplasia. Gynecol Oncol 2014; 132:377-82. [PMID: 24388920 DOI: 10.1016/j.ygyno.2013.12.034] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [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: 10/25/2013] [Revised: 12/22/2013] [Accepted: 12/24/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In vitro data and pilot data suggest that green tea catechins may possess chemopreventive activity for cervical cancer and precursor lesions. We conducted a randomized, double-blind, placebo-controlled trial of Polyphenon E (decaffeinated and enriched green tea catechin extract) in women with persistent human papillomavirus (HPV) infection and low-grade cervical intraepithelial neoplasia (CIN1) to evaluate the potential of Polyphenon E for cervical cancer prevention. METHODS Ninety-eight eligible women were randomized to receive either Polyphenon E (containing 800 mg epigallocatechin gallate) or placebo once daily for 4 months. The primary study outcome was oncogenic HPV clearance and clearance of CIN1. RESULTS Polyphenon E was shown to be acceptable, safe and well tolerated. There was no difference in the response rate by treatment allocation. Complete response, defined as negative for high-risk HPV and normal histopathology, was noted in 7 (17.1%) and 6 (14.6%) women in the Polyphenon E and placebo arms, respectively. Progression, defined as persistent oncogenic HPV with histopathologic evidence of progression, was more common in the Polyphenon E group than in the placebo group [6 (14.6%) vs. 3 (7.7%)]. CONCLUSION Based on the largest randomized placebo-controlled trial of a green tea extract for HPV related cervical disease, we conclude that 4 months of Polyphenon E intervention did not promote the clearance of persistent high-risk HPV and related CIN1. Further studies may be necessary to better delineate the risk factors for persistent HPV infection and biology of the disease to facilitate the evaluation of chemopreventive strategies.
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Affiliation(s)
- Francisco A R Garcia
- Center of Excellence in Women's Health, The University of Arizona, Tucson, AZ 85724, United States; University of Arizona Cancer Center, Tucson, AZ 85724, United States
| | - Terri Cornelison
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD 20892, United States
| | - Tomas Nuño
- Center of Excellence in Women's Health, The University of Arizona, Tucson, AZ 85724, United States; University of Arizona Cancer Center, Tucson, AZ 85724, United States.
| | | | - John W Byron
- The Southern Pines Women's Health Center, Southern Pines, NC 28388, United States
| | - Chiu-Hsieh Hsu
- University of Arizona Cancer Center, Tucson, AZ 85724, United States
| | - David S Alberts
- University of Arizona Cancer Center, Tucson, AZ 85724, United States
| | - H-H Sherry Chow
- University of Arizona Cancer Center, Tucson, AZ 85724, United States
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Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain JM, Garcia FAR, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki AB, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER, Chelmow D, Herzig A, Kim JJ, Kinney W, Herschel WL, Waldman J. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. J Low Genit Tract Dis 2012; 16:175-204. [PMID: 22418039 PMCID: PMC3915715 DOI: 10.1097/lgt.0b013e31824ca9d5] [Citation(s) in RCA: 237] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from six working groups, and a recent symposium co-sponsored by the ACS, American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology (ASCP), which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (e.g., management of screen positives and screening interval for screen negatives) of women after screening, age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16/18 infections.
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Affiliation(s)
- Debbie Saslow
- Breast and Gynecologic Cancer, Cancer Control Science Department, American Cancer Society, Atlanta, GA 30303, USA.
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Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, Garcia FAR, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki AB, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin 2012; 62:147-72. [PMID: 22422631 PMCID: PMC3801360 DOI: 10.3322/caac.21139] [Citation(s) in RCA: 781] [Impact Index Per Article: 65.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from 6 working groups, and a recent symposium cosponsored by the ACS, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology, which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (eg, the management of screen positives and screening intervals for screen negatives) of women after screening, the age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections.
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Affiliation(s)
- Debbie Saslow
- Cancer Control Science Department, American Cancer Society, Atlanta, GA 30303, USA.
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Garcia FAR, Freund KM, Berlin M, Digre KB, Dudley DJ, Fife RS, Gabeau G, Geller SE, Magnus JH, Trott JA, White HF. Progress and priorities in the health of women and girls: a decade of advances and challenges. J Womens Health (Larchmt) 2012; 19:671-80. [PMID: 20201706 DOI: 10.1089/jwh.2009.1627] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Following the initial wave of federal support to address women's health, there is a need to assess successes and determine the next priorities to advance the health of women. The objective of this study was to systematically collect expert opinion on the major advances in women's health in the past decade and priorities for women's health research and service in the coming decade. METHODS We utilized a Delphi method to query the leadership from academic and community Centers of Excellence in Women's Health, as designated by the Department of Health and Human Services. Leaders from 36 of the 48 centers responded to a series of questions about the major advances and critical indicators to evaluate future needs in women's health. We utilized a social ecology model framework to organize the responses to each question. RESULTS The experts identified increased health education for women and increased empowerment of women across multiple spheres as the major advances positively impacting the health of women. The experts selected the following areas as the most important indicators to measure the status of the health of women in the future: health education and promotion, rates and impact of interpersonal violence against women, and access to healthcare. The major advances and measures of the health of women did not focus on specific changes to individual women in illness management, clinical care, or individual behavioral change. CONCLUSIONS As we move to address health reform, we must be able to recognize and incorporate a broad perspective on public health and policy initiatives critical to the health and wellness of women and girls and, therefore, central to the well-being of the nation.
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Affiliation(s)
- Francisco A R Garcia
- Obstetrics and Gynecology and Public Health, Center of Excellence in Women's Health, The University of Arizona, Tucson, Arizona, USA.
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Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, Garcia FAR, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki AB, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. Am J Clin Pathol 2012; 137:516-42. [PMID: 22431528 DOI: 10.1309/ajcptgd94evrsjcg] [Citation(s) in RCA: 526] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from 6 working groups, and a recent symposium cosponsored by the ACS, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology, which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (eg, the management of screen positives and screening intervals for screen negatives) of women after screening, the age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections.
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Bartels PH, Garcia FAR, Trimble CL, Kauderer J, Curtin J, Lim PC, Hess LM, Silverberg S, Zaino RJ, Yozwiak M, Bartels HG, Alberts DS. Karyometry in atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Gynecol Oncol 2011; 125:129-35. [PMID: 22155796 DOI: 10.1016/j.ygyno.2011.12.422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 11/30/2011] [Accepted: 12/02/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVES Treatment for atypical endometrial hyperplasia (AEH) is based on pathologic diagnosis. About 40% of AEH is found to be carcinoma at surgery. This study's objective is to derive an objective characterization of nuclei from cases diagnosed as AEH or superficially invasive endometrial cancer (SIEC). METHODS Cases from GOG study 167A were classified by a central pathology committee as AEH (n=39) or SIEC (n=39). High resolution digitized images of cell nuclei were recorded. Features of the nuclear chromatin pattern were computed. Classification rules were derived by discriminant analysis. RESULTS Nuclei from cases of AEH and SIEC occupy the same range on a progression curve for endometrial lesions. Cases of AEH and SIEC both comprise nuclei of two phenotypes: hyperplastic characteristics and premalignant/neoplastic characteristics. The principal difference between AEH and SIEC is the percentage of premalignant/neoplastic nuclei. When this percentage approaches 50-60% superficial invasion is likely. SIEC may develop already from lesions at the low end of the progression curve. CONCLUSIONS AEH comprises cases which may constitute a low risk group involving <40% of AEH cases. These cases hold a percentage of <20% of nuclei of a preneoplastic phenotype. AEH cases from the central and high end of progression have >40% of nuclei of preneoplastic phenotype. Nuclei of the preneoplastic phenotype in AEH lesions are almost indistinguishable from nuclei in SIEC, where this percentage exceeds 60%. The percentage of nuclei of the preneoplastic phenotype in AEH esions might serve as criterion for assessment of risk for the development of invasive disease.
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Einstein MH, Garcia FAR, Mitchell AL, Day SP. Age-stratified performance of the Cervista HPV 16/18 genotyping test in women with ASC-US cytology. Cancer Epidemiol Biomarkers Prev 2011; 20:1185-9. [PMID: 21527581 DOI: 10.1158/1055-9965.epi-11-0116] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The objective of this study was to evaluate the clinical performance of the Cervista HPV 16/18 genotyping test for detection of human papilloma virus (HPV) 16 and 18 in cervical cytology specimens in women stratified by age. METHODS In a multicenter, prospective clinical study, ThinPrep specimens were tested for the presence of HPV 16 and 18 using the HPV 16/18 genotyping test. Genotyping results from women with atypical squamous cells of undetermined significance or greater cytology were compared with local colposcopy and/or histology results. Sensitivity, specificity, and negative and positive predictive values (NPV and PPV) were determined. RESULTS The prevalence of cervical intraepithelial neoplasia (CIN) 2(+) in subjects positive for HPV 16/18 was 6.6% and 4.1% for women <30 and ≥30 years of age, respectively. The sensitivity of the test was 70.0% (95% CI: 54.6-81.9) and 66.7% (95% CI: 46.7-82.0) in women <30 and ≥30 years, respectively. The NPV was 95.5% (95% CI: 93.4-97.6) in women <30 years and 96.6% (95% CI: 94.8-98.5) in women ≥30 years. Specificity was higher in women ≥30 years (79.9%; 95% CI: 74.9-84.2) than women <30 years (61.9%; 95% CI: 57.1-66.4). The PPV was 15.2% (95% CI: 12.7-19.1) in women <30 years and 21.9% (95% CI: 17.0-30.7) in women ≥30 years. CONCLUSIONS The performance of the Cervista HPV 16/18 genotyping test for predicting ≥CIN 2 is what would be expected across the key ≥CIN 2 age strata. IMPACT HPV 16/18 genotyping may help further stratify women with a greater potential to develop cervical cancer.
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Affiliation(s)
- Mark H Einstein
- Albert Einstein College of Medicine and Albert Einstein Cancer Center, Montefiore Medical Center, Bronx, NY 10461, USA.
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Scarinci IC, Garcia FAR, Kobetz E, Partridge EE, Brandt HM, Bell MC, Dignan M, Ma GX, Daye JL, Castle PE. Cervical cancer prevention: new tools and old barriers. Cancer 2010; 116:2531-42. [PMID: 20310056 DOI: 10.1002/cncr.25065] [Citation(s) in RCA: 133] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cervical cancer is the second most common female tumor worldwide, and its incidence is disproportionately high (>80%) in the developing world. In the United States, in which Papanicolaou (Pap) tests have reduced the annual incidence to approximately 11,000 cervical cancers, >60% of cases are reported to occur in medically underserved populations as part of a complex of diseases linked to poverty, race/ethnicity, and/or health disparities. Because carcinogenic human papillomavirus (HPV) infections cause virtually all cervical cancer, 2 new approaches for cervical cancer prevention have emerged: 1) HPV vaccination to prevent infections in younger women (aged < or =18 years) and 2) carcinogenic HPV detection in older women (aged > or =30 years). Together, HPV vaccination and testing, if used in an age-appropriate manner, have the potential to transform cervical cancer prevention, particularly among underserved populations. Nevertheless, significant barriers of access, acceptability, and adoption to any cervical cancer prevention strategy remain. Without understanding and addressing these obstacles, these promising new tools for cervical cancer prevention may be futile. In the current study, the delivery of cervical cancer prevention strategies to these US populations that experience a high cervical cancer burden (African-American women in South Carolina, Alabama, and Mississippi; Haitian immigrant women in Miami; Hispanic women in the US-Mexico Border; Sioux/Native American women in the Northern Plains; white women in the Appalachia; and Vietnamese-American women in Pennsylvania and New Jersey) is reviewed. The goal was to inform future research and outreach efforts to reduce the burden of cervical cancer in underserved populations.
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Affiliation(s)
- Isabel C Scarinci
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294-4410, USA.
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Abstract
As physician-essayist Lewis Thomas has urged, ignorance-based courses and curricula are urgently needed in medical education to prepare future generations of scientific physicians and physician-scientists for the uncertain, rapidly changing world ahead. This article reviews the evolving concept of ignorance in general and specifically in medicine and its relationship to knowledge. Issues about goals, content, and assessment of such ignorance-based courses are discussed along with the experience of the University of Arizona's National Institutes of Health-sponsored Summer Institute on Medical Ignorance for medical student researchers and disadvantaged high school students. Summer Institute on Medical Ignorance activities can be readily replicated or adopted in their entirety or partially in both live and Internet-based formats. These will serve to introduce medical ignoramics and questioning as a way to balance the information-overloaded medical curriculum.
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Affiliation(s)
- Marlys H Witte
- Department of Surgery, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ 85724, USA.
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Castle PE, Dockter J, Giachetti C, Garcia FAR, McCormick MK, Mitchell AL, Holladay EB, Kolk DP. A cross-sectional study of a prototype carcinogenic human papillomavirus E6/E7 messenger RNA assay for detection of cervical precancer and cancer. Clin Cancer Res 2007; 13:2599-605. [PMID: 17473189 DOI: 10.1158/1078-0432.ccr-06-2881] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate carcinogenic human papillomavirus (HPV) mRNA for E6 and E7 mRNA detection on clinical specimens to identify women with cervical precancer and cancer. EXPERIMENTAL DESIGN We evaluated a prototype assay that collectively detects oncogenes E6/E7 mRNA for 14 carcinogenic HPV genotypes on a sample of liquid cytology specimens (n=531), masked to clinical data and to the presence of HPV genotypes detected by PGMY09/11 L1 consensus primer PCR assay. RESULTS We found an increasing likelihood of testing positive for carcinogenic HPV E6/E7 mRNA with increasing severity of cytology (P(Trend) < 0.0001) and histology (P(Trend) < 0.0001), with 94% of cervical intraepithelial neoplasia grade 3 (CIN3) histology cases (46 of 49) and all five cancer cases testing positive for carcinogenic HPV E6/E7 mRNA. Overall, fewer specimens tested positive for carcinogenic HPV E6/E7 mRNA than for carcinogenic HPV DNA (P<0.0001, McNemar's chi(2) test), especially in women with <CIN1 (P<0.0001). We also found that using a higher positive cutpoint for detection of carcinogenic HPV E6/E7 mRNA improved the association of positive test results with cervical precancer and cancer by reducing the number of test positives in women without precancer without reducing clinical sensitivity for cervical precancer and cancer compared with detection of carcinogenic HPV E6/E7 mRNA using a lower positive cutpoint by the same assay and with detection of carcinogenic HPV DNA. CONCLUSIONS We found that carcinogenic HPV E6/E7 mRNA is a potentially useful biomarker for detection of cervical precancer and cancer and warrants further evaluation.
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Affiliation(s)
- Philip E Castle
- Division of Cancer Epidemiology, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, Maryland 20892-7234, USA.
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Castle PE, Sadorra M, Garcia FAR, Cullen AP, Lorincz AT, Mitchell AL, Whitby D, Chuke R, Kornegay JR. Mouthwash as a low-cost and safe specimen transport medium for human papillomavirus DNA testing of cervicovaginal specimens. Cancer Epidemiol Biomarkers Prev 2007; 16:840-3. [PMID: 17416781 DOI: 10.1158/1055-9965.epi-06-0909] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The usefulness of mouthwash as a transport medium for cervical specimens for carcinogenic human papillomavirus (HPV) DNA testing has not been evaluated. Two cervical specimens were collected from each of 34 patients, with one placed in mouthwash (Scope, Proctor and Gamble, Inc.) and the other in a liquid cytology medium commonly used for HPV DNA testing in alternating order. Paired specimens were tested by a PCR assay for carcinogenic HPV and a PCR HPV genotyping assay for 37 HPV types at 0, 3, and 6 weeks after collection; the results of the HPV genotyping assay were categorized into HPV risk groups according to cancer risk (HPV-16 > HPV-18 > other carcinogenic HPV types > noncarcinogenic HPV types > negative). After 4 months of storage, specimens were tested using a second, non-PCR test for carcinogenic HPV. We observed a >or=94% total agreement and kappa values of >or=0.88 between media at each time point for PCR-detected carcinogenic HPV. We observed a >or=74% total agreement, >or=0.62 unweighted kappa, and >or=0.75 linearly weighted kappa between media at each time point for PCR-detected HPV cancer risk category. Finally, we observed an 88% total agreement and kappa of 0.77 between media for carcinogenic HPV detection using a second test after 4 months of storage. We suggest that mouthwash might be used as a low-cost, safe, nonflammable storage and transport medium for cervical specimens for HPV DNA testing in cervical cancer screening programs.
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Affiliation(s)
- Philip E Castle
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, Room 5004, EPS MSC 7234, Bethesda, MD 20892-7234, USA.
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Barker B, Garcia FAR, Warner J, Lozerski J, Hatch K. Baseline inaccuracy rates for the comparison of cervical biopsy to loop electrosurgical excision histopathologic diagnoses. Am J Obstet Gynecol 2002; 187:349-52. [PMID: 12193923 DOI: 10.1067/mob.2002.123199] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to quantify the baseline inaccuracies in histopathologic diagnosis between colposcopically directed cervical biopsies and loop electrosurgical excision procedure specimens. STUDY DESIGN A retrospective review was made of cervical biopsies and loop electrosurgical excision procedure pairs (n = 448) that were performed at the University of Arizona between 1992 and 2000. Agreement was assessed by kappa statistics and Spearman rho coefficients. Subgroup analysis was performed (n = 139) to assess pairs with significant inaccuracy between biopsy and loop electrosurgical excision procedure, when these were performed within 28 days of each other. RESULTS Eighty-one percent agreement was found between cervical biopsy and loop electrosurgical excision procedure histopathologic diagnoses, when compared to within 1 degree (kappa, 0.73; P <.0001). A discrepancy that would be attributed to regression or progression was found: mild biopsy (regression, none by definition; progression, 4%), moderate biopsy (regression, 9%; progression, 0%), and severe biopsy (regression, 26%; progression, 0%). CONCLUSION Even when colposcopically directed cervical biopsy correlates strongly with loop electrosurgical excision procedure histopathologic diagnosis, there is a definable percentage of patients for whom there is a discrepancy between these 2 diagnoses. This discrepancy represents an inherent inaccuracy of the diagnostic testing modality and should not be interpreted as progression or regression of disease.
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Affiliation(s)
- Bel Barker
- University of Arizona Health Sciences Center, Tucson, 85724-5078, USA.
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Garcia FAR, Davis JR, Hatch K, Alberts DS, Thompson D, Bartels PH. Karyometry in endometrial adenocarcinoma of different grades. Anal Quant Cytol Histol 2002; 24:93-102. [PMID: 12026057] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To characterize nuclei from adenocarcinoma of the endometrium of different grades in order to establish whether significantly different nuclear subpopulations exist. STUDY DESIGN A total of 1,400 nuclei from 14 cases of adenocarcinoma of the endometrium of grades 1, 2 and 3 were recorded, and 600 nucleifrom normal, secretory phase glandular endometrial epithelium were used as a reference data set. Karyometric features were computed and a discriminant function derived to define a trend in feature values for nuclei from lesions of different grades. The nuclei from lesions of different grades were processed by a nonsupervised learning algorithm in an effort to detect and define subpopulations. RESULTS Nuclei from grade 1 lesions represented a near-diploid stemline, whereas nuclei from grade 3 lesions formed an aneuploid set with a mode around 3N. The existence of three subpopulations with statistically different nuclear chromatin patterns could be shown for nuclei from each grade. In each grade these three subpopulations occupied the same relative position in feature space. For grade 1 lesions all three subpopulations were near diploid, for grade 3 lesions all three were approximately triploid. CONCLUSION The nuclei in adenocarcinoma of the endometrium form a heterogeneous set, with subpopulations of distinctly different chromatin patterns and different ploidy. This should be taken into consideration in assessing the efficacy of chemopreventive intervention.
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Affiliation(s)
- Francisco A R Garcia
- Arizona Cancer Center, Optical Sciences Center, Department of Pathology, University of Arizona, Tucson 85721, USA
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