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Alsoghier A, Riordain RN, Fedele S, Porter S. Patient and clinician perspectives of information needs concerning oral epithelial dysplasia. Oral Dis 2024; 30:2166-2175. [PMID: 37455497 DOI: 10.1111/odi.14668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/24/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Individuals diagnosed with a chronic oral disease that increase the risk of mouth cancer, such as oral epithelial dysplasia (OED), require appropriate knowledge to make informed decisions. The present study aimed to assess whether patient information needs of a group of patients concerning dysplasia were met and to what degree clinicians agree with patients on 'important' topics. SUBJECTS AND METHODS This represented secondary analyses of a cross-sectional study to assess the information needs of 86 patients diagnosed with dysplasia compared with those of 77 clinicians using the validated OED Information Needs Questionnaire. Descriptive, concordance and regression analyses were performed for the collected data. RESULTS The mean and median total scores for all items in the amount of information received subscale were 2.33 and 2.44, indicating overall unmet needs concerning dysplasia. Clinicians were generally able to predict topics of greatest importance to patients, although their scores were mainly lower than those of patients (k = 0.06). There was a higher agreement between patients (k = 0.25) than clinicians (k = 0.09). CONCLUSION Clinicians are encouraged to assess a patient's information needs to ensure tailored and patient-centred communication concerning OED during all clinical consultations.
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Affiliation(s)
- Abdullah Alsoghier
- UCL Eastman Dental Institute, University College London, London, UK
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Richeal Ni Riordain
- UCL Eastman Dental Institute, University College London, London, UK
- Cork University Dental School and Hospital, University College Cork, Cork, Ireland
| | - Stefano Fedele
- UCL Eastman Dental Institute, University College London, London, UK
- NIHR University College London Hospitals, Biomedical Research Centre, London, UK
| | - Stephen Porter
- UCL Eastman Dental Institute, University College London, London, UK
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2
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JaKa MM, Henderson MSG, Gillesby AD, Zibley LJ, Basile SM, Michalowicz BS, Worley D, Kharbanda EO, Asche SE, Mabry PL, Rindal BD. "I'm Torn": Qualitative Analysis of Dental Practitioner-Perceived Barriers, Facilitators, and Solutions to HPV Vaccine Promotion. Healthcare (Basel) 2024; 12:780. [PMID: 38610203 PMCID: PMC11011463 DOI: 10.3390/healthcare12070780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
The human papillomavirus (HPV) vaccine can prevent HPV-related oropharyngeal cancers. Dental practitioners are uniquely positioned to promote HPV vaccines during routine dental care but experience barriers to doing so. Qualitative interviews were conducted with dental practitioners to understand barriers and inform intervention strategies to promote HPV vaccines. Dental practitioners were invited to participate in phone interviews about knowledge, self-efficacy, and the fear of negative consequences related to HPV vaccine promotion as well as feedback on potential interventions to address these barriers. Interviews were audio recorded, transcribed, and analyzed using rapid qualitative analysis with a sort-and-sift matrix approach. Interviews were completed with 11 practitioners from six dental clinics (avg. 31 min). Though most thought HPV vaccination was important, they lacked detailed knowledge about when and to whom the vaccine should be recommended. This led to a hypothesized need for discussions of sexual history, feelings of limited self-efficacy to make the recommendation, and fear of patient concerns. Still, practitioners were supportive of additional training opportunities and provided input into specific interventions. The nuance of how these barriers were described by practitioners, as well as the possible solutions they identified, will help shape future interventions supporting HPV vaccine promotion in dental care.
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Affiliation(s)
- Meghan M. JaKa
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN 55425, USA
| | - Maren S. G. Henderson
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN 55425, USA
| | - Amanda D. Gillesby
- Center for Oral Health Integration, HealthPartners Institute, Bloomington, MN 55425, USA (B.S.M.); (B.D.R.)
| | - Laura J. Zibley
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN 55425, USA
| | - Sarah M. Basile
- Center for Oral Health Integration, HealthPartners Institute, Bloomington, MN 55425, USA (B.S.M.); (B.D.R.)
| | - Bryan S. Michalowicz
- Center for Oral Health Integration, HealthPartners Institute, Bloomington, MN 55425, USA (B.S.M.); (B.D.R.)
| | - Donald Worley
- HealthPartners Dental Group, Bloomington, MN 55425, USA;
| | | | | | | | - Brad D. Rindal
- Center for Oral Health Integration, HealthPartners Institute, Bloomington, MN 55425, USA (B.S.M.); (B.D.R.)
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3
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Fonsêca TC, Jural LA, Marañón-Vásquez GA, Magno MB, Roza ALOC, Ferreira DMTP, Maia LC, Romañach MJ, Agostini M, Abrahão AC. Global prevalence of human papillomavirus-related oral and oropharyngeal squamous cell carcinomas: a systematic review and meta-analysis. Clin Oral Investig 2023; 28:62. [PMID: 38158517 DOI: 10.1007/s00784-023-05425-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To conduct a systematic review to determine the global prevalence of HPV in oral squamous cell carcinoma (OSCC) and oropharyngeal squamous cell carcinoma (OPSCC). MATERIALS AND METHODS Literature was searched through October 2022 in main databases to address the question "What is the global prevalence of Human Papillomavirus in oral and oropharyngeal cancer?" Studies had to identify HPV by PCR, ISH, or p16 immunohistochemistry to be eligible. Quality was assessed using the JBI checklist for prevalence studies. Meta-analyses were performed, and reporting followed PRISMA guidelines. RESULTS Sixty-five studies were included, and most of them had methodological limitations related to sampling and the HPV detection tool. The pooled prevalence of HPV-positivity was 10% (event rate = 0.1; 95% CI: 0.07, 0.13; P < 0.01; I2 = 88%) in the oral cavity and 42% (event rate = 0.42; 95% CI: 0.36, 0.49; P = 0.02; I2 = 97%) in oropharynx. The highest HPV prevalence in OSCC was reached by Japan, meanwhile, in OPSCC, Finland and Sweden were the most prevalent. HPV16 is the genotype most frequent with 69% in OSCC and 89% in OPSCC, being the tonsils the intraoral location more affected by HPV (63%, p < 0.01, I2 76%). CONCLUSION The evidence points to an apparent burden in HPV-related OPSCC, mostly in North America, Northern Europe, and Oceania, especially due to the HPV16 infection suggesting different trends across continents. CLINICAL RELEVANCE This updated systematic review and meta-analysis provide sufficient evidence about the global HPV prevalence in OSCC and OPSCC and the most frequent HPV subtype worldwide.
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Affiliation(s)
- Thamyres Campos Fonsêca
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil
| | - Lucas Alves Jural
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Guido Artemio Marañón-Vásquez
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil
| | - Aline Correa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil.
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Alves CGB, Ribeiro ACP, Brandão TB, Tonaki JO, Pedroso CM, Rivera C, Epstein JB, Migliorati CA, Kowalski LP, Mak MP, Castro G, Lopes MA, Santos-Silva AR. Patient's perceptions of oral and oropharyngeal cancer diagnosis disclosure: communication aspects based on SPIKES protocol. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:518-529. [PMID: 36740563 DOI: 10.1016/j.oooo.2022.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/28/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Breaking bad medical news is a complex task of clinical practice. The manner in which this is done has a significant impact on patients. This study aimed to assess patient's perceptions regarding oral and oropharyngeal cancer diagnosis disclosure according to the "SPIKES" protocol. STUDY DESIGN This cross-sectional study used a questionnaire with 21 SPIKES-based items. The questionnaire was administered to 100 patients with recently diagnosed oral and oropharyngeal squamous cell carcinoma who evaluated each item according to their preference and experience. RESULTS Nineteen items showed a significant difference between patient's preference and recalled experience. Eighteen of these items showed lower experience scores primarily related to the amount of information desired by patients, presence of a companion, time to express feelings, and summary of information. Most patients preferred receiving as much information as possible about the diagnosis. However, only 35% reported that they had obtained sufficient information. Patients who were aware of cancer diagnostic suspicion had better communication experiences. CONCLUSIONS Protocols may be useful to guide health professionals to support patient-centered strategies to disclose oral cancer diagnoses.
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Affiliation(s)
- Carolina G B Alves
- Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, University of São Paulo Medical School (ICESP-FMUSP), São Paulo, Brazil
| | - Ana Carolina Prado Ribeiro
- Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, University of São Paulo Medical School (ICESP-FMUSP), São Paulo, Brazil
| | - Thaís Bianca Brandão
- Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, University of São Paulo Medical School (ICESP-FMUSP), São Paulo, Brazil
| | - Juliana O Tonaki
- Psychology Service, Instituto do Câncer do Estado de São Paulo, University of São Paulo Medical School (ICESP-FMUSP), São Paulo, Brazil
| | - Caique Mariano Pedroso
- Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - César Rivera
- Oral Medicine and Pathology Research Group, Faculty of Health Sciences, University of Talca (UTALCA), Talca, Maule Region, Chile
| | - Joel B Epstein
- Cedars-Sinai Health System, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | | | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery, University of São Paulo Medical School (FMUSP), São Paulo, Brazil
| | - Milena Perez Mak
- Department of Medical Oncology, Instituto do Câncer do Estado de São Paulo, University of São Paulo Medical School (ICESP-FMUSP), São Paulo, Brazil
| | - Gilberto Castro
- Department of Medical Oncology, Instituto do Câncer do Estado de São Paulo, University of São Paulo Medical School (ICESP-FMUSP), São Paulo, Brazil
| | - Marcio Ajudarte Lopes
- Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
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Galeshi M, Shirafkan H, Yazdani S, Motaghi Z. Reproductive health needs of Human papillomavirus (HPV) positive women: A systematic review. PLoS One 2022; 17:e0266819. [PMID: 36095006 PMCID: PMC9467316 DOI: 10.1371/journal.pone.0266819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 08/26/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives Human papillomavirus is one of the most important causes of cervical cancer. Participating in an HPV test and receiving an HPV diagnosis can create questions about the needs and preferences. The present systematic review was conducted to determine the reproductive health needs of women with HPV. Methods We searched PubMed, Scopus, Web of Science, Google Scholar and Magiran, SID and Iranmedex. Without language restrictions and time constraints. We also searched the grey literature and carried out forward/backward citation searches. Results In the first, 1056 articles were retrieved, and, after removing them, 13 articles published were entered. The studies were qualitative (N = 9), quantitative (N = 3), and one was unclear. Most qualitative studies collected data using individual interviews (N = 7), two qualitative studies, narratives of HPV patients from a website of patient experiences and questions. Women wanted further information on different HPV viral types, transmission, implications for sexual partners, prevalence, latency and regression of HPV, their management options and the implications of infection for cancer risk and fertility. Women’s experience of searching the Internet for further information about HPV was reported as difficult, anxiety provoking and contributing to the stigma of the infection because information was often located in the context of other sexually transmitted infections, with multiple sexual partners highlighted as a risk factor for infection. Conclusion Surveys showed that the majority of women had unanswered questions about their HPV test results. The information that women thought was helpful in interpreting their test results included having a high-risk type of HPV, and cancer survival statistics for the virus. Women also needed information about sexual transmission, how HPV tested positive in a long-term relationship, and the potential consequences for their partners and the risk of re-infection. Younger women had questions about whether HPV could affect fertility.
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Affiliation(s)
- Mina Galeshi
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hoda Shirafkan
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shahla Yazdani
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Motaghi
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
- * E-mail:
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Henry M, Arnovitz E, Frenkiel S, Hier M, Zeitouni A, Kost K, Mlynarek A, Black M, MacDonald C, Richardson K, Mascarella M, Morand GB, Chartier G, Sadeghi N, Rosberger Z. Psychosocial outcomes of human papillomavirus (HPV)- and non-HPV-related head and neck cancers: A longitudinal study. Psychooncology 2022; 31:185-197. [PMID: 35122670 DOI: 10.1002/pon.5803] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Human papillomavirus (HPV) has prompted a need to further investigate how this new biomarker changes the head and neck cancer (HNC) psychosocial landscape. This study aimed to: (a) characterize the sociodemographic, psychological, and social profiles of patients with HPV-positive versus -negative squamous cell carcinoma of the head and neck; and (b) identify how HPV status contributes to anxiety and depression (primary outcome), quality of life (QoL), and sexuality needs. METHODS We conducted a prospective longitudinal study of 146 patients newly diagnosed with oral, oropharyngeal, nasopharyngeal, and hypopharyngeal cancer. Seventy-nine patients were HPV-positive and 67 HPV-negative. Patients completed self-administered psychometric measures upon HNC and 3-month follow-up, and Structured Clinical Interviews for DSM Diagnoses. RESULTS Patients with HPV-negative tumors generally presented with higher anxiety and depression and lower QoL immediately post-HNC diagnosis (<2 weeks) compared to HPV-positive cancers. A Major Depressive Disorder (MDD) immediately post-HNC diagnosis negatively affected patients' anxiety and depression and QoL levels upon diagnosis only when the cancer was HPV-positive. Immediately posttreatment, HPV status was not associated with outcomes. A previous history of suicidal ideation, and upon cancer diagnosis cigarette smoking, anxiety and depression, and feeling close to one's partner were instead explanatory. CONCLUSION While patients with HPV-positive HNC generally present with initially lower psychological distress, their vulnerability immediately posttreatment indicates an equal need for support. Head and neck clinics may need to better address MDD, anxiety and depression, a prior history of suicidal ideation, health behavior change, and quality of relationships.
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Affiliation(s)
- Melissa Henry
- McGill University, Montreal, Quebec, Canada.,Jewish General Hospital, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada
| | - Emily Arnovitz
- McGill University, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada
| | - Saul Frenkiel
- McGill University, Montreal, Quebec, Canada.,Jewish General Hospital, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Michael Hier
- McGill University, Montreal, Quebec, Canada.,Jewish General Hospital, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada
| | - Anthony Zeitouni
- McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Karen Kost
- McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Alex Mlynarek
- McGill University, Montreal, Quebec, Canada.,Jewish General Hospital, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Martin Black
- McGill University, Montreal, Quebec, Canada.,Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Keith Richardson
- McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | | | - Nader Sadeghi
- McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Zeev Rosberger
- McGill University, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada
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Qaderi K, Geranmayeh M, Farnam F, Sheikh Hasani S, Mirmolaei ST. Understanding HPV-positive women's needs and experiences in relation to patient-provider communication issues: a qualitative study. BMC Health Serv Res 2021; 21:286. [PMID: 33784992 PMCID: PMC8011207 DOI: 10.1186/s12913-021-06283-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/15/2021] [Indexed: 11/29/2022] Open
Abstract
Background HPV testing has been integrated in cervical cancer screening program. Patient-providers relationship is extremely important to improve cervical cancer screening outcomes. This qualitative study aims to understand HPV-positive women’s needs and preferences about HCPs and patient-provider communication based on their experiences of accessing primary and specialized care. Methods We conducted 40 semi-structured interviews with HPV-positive women. Recorded interviews transcribed and analyzed using conventional content analysis approach. Results The analysis of the data led to the extraction of three main categories, including: provider’s communication and counseling skills, commitment to professional principles, and knowledgeable and competent provider. Women needed understandable discussion about HPV, emotional support and acceptance, receiving HPV-related guidance and advice, and some considerations during clinical appointments. Women needed HCPs to treat them respectfully, gently and with non-judgmental attitude. “Precancerous” and “high-risk” words and watching colposcopy monitor during procedure had made women anxious. Weak referral system and limited interactions among gynecologists and other HCPs highlighted by participants. Conclusion The results of this study, based on the experiences and perceptions of HPV women receiving health care, contain messages and practical tips to healthcare providers at the primary and specialized levels of care to facilitate patient-provider communication around HPV. Providers need to approach the discussion of HPV with sensitivity and take individual needs and preferences into account to improve the HPV-positive women’s healthcare experience. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06283-w.
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Affiliation(s)
- Kowsar Qaderi
- Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Eastern Nosrat st. Tohid sq, Tehran, 141973317, Iran
| | - Mehrnaz Geranmayeh
- Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Eastern Nosrat st. Tohid sq, Tehran, 141973317, Iran
| | - Farnaz Farnam
- Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Eastern Nosrat st. Tohid sq, Tehran, 141973317, Iran
| | - Shahrzad Sheikh Hasani
- Gynecology Oncology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Seyedeh Tahereh Mirmolaei
- Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Eastern Nosrat st. Tohid sq, Tehran, 141973317, Iran.
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Iqbal MS, Gray I, Carlson K, Kovarik J, Kelly C. “Awareness and knowledge of human papillomavirus in UK women aged 25 years and over: Results from a cross‐sectional internet‐based survey”: Lessons for HPV‐positive oropharyngeal cancer. Eur J Cancer Care (Engl) 2020; 29:e13293. [DOI: 10.1111/ecc.13293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/08/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Muhammad Shahid Iqbal
- Department of Clinical Oncology Northern Centre for Cancer Care The Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK
| | - Isabel Gray
- Department of Clinical Oncology Northern Centre for Cancer Care The Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK
| | - Kristy Carlson
- Department of Clinical Oncology Northern Centre for Cancer Care The Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK
| | - Josef Kovarik
- Department of Clinical Oncology Northern Centre for Cancer Care The Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK
| | - Charles Kelly
- Department of Clinical Oncology Northern Centre for Cancer Care The Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK
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