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Manna P, Gallo A, Bitonti G, Venturella R, Di Carlo C. Efficacy of a Triticum vulgare Extract as a Treatment of Cervical Ectropion: A Prospective Observational Cohort Study. J Low Genit Tract Dis 2024:00128360-990000000-00112. [PMID: 38661363 DOI: 10.1097/lgt.0000000000000817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVES To assess the effectiveness of a topical treatment for cervical ectropion with vaginal ovules containing aqueous extract of Triticum vulgare. METHODS Prospective observational cohort study conducted between November 2020 and November 2022 at the colposcopy clinics of 2 different hospitals. Sexually active patients with a colposcopic diagnosis of cervical ectropion, awaiting ablative procedure, were included in the study and prescribed medical therapy with vaginal T. vulgare ovules (group 1) or wait-and-see therapy (group 2). At both enrollment and 2-month follow-up, a symptomatologic evaluation recording the intensity of postcoital bleeding, leucorrhea, and dyspareunia was performed with a Visual Analog Scale (VAS) questionnaire, and a colposcopic examination was performed, calculating the size of the ectropion area. RESULTS A total of 116 patients (58 in group 1 and 58 in group 2) were included. Topical treatment with vaginal ovules containing aqueous extract of T. vulgare for 2 months resulted in significant decrease of symptoms related to cervical ectropion and significant reduction of the size of the ectropion area. CONCLUSIONS Our results support the efficacy of topical treatment with vaginal ovules containing aqueous extract of T. vulgare for symptomatic cervical ectropion; our study also suggests that expectant management, despite being widely practiced, seems to lead to a worsening of the natural history of ectropion.
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Affiliation(s)
- Paolo Manna
- Department of Clinical and Experimental Medicine, Obstetrics and Gynecology Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Alessandra Gallo
- Department of Public Health, School of Medicine, University of Naples "Federico II", Naples, Italy
| | - Giovanna Bitonti
- Department of Clinical and Experimental Medicine, Obstetrics and Gynecology Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Roberta Venturella
- Department of Clinical and Experimental Medicine, Obstetrics and Gynecology Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Costantino Di Carlo
- Department of Public Health, School of Medicine, University of Naples "Federico II", Naples, Italy
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Abstract
Introduction: Cervical erosion and squamouse intraepithelial lesion of low grade are most common gynecological problems of women. These changes on cervix are cause of painful coitus and enhanced vaginal secretion. Cryotherapy is widely accepted method in treating these changes and sympthoms. Aim: The aim of this study is to examine the efficiency of cryotherapy in eliminating erosion of cervics and LSIL, as well as conditions following these states. Patients and methods: Cryotherapy was performed in 124 women with cervical erosion (N-74) and LSIL (N-50). Sympthoms that were followed are: vaginal secretion, abnormal vaginal bleeding and pain. Assessment of epithelisation of cervix and evaluation of sympthoms were done 4 and 6 weeks after cryotherapy and PAP test after 4 months in women with LSIL. Statistical method used in result processing was X2 test. Results: The average age of examined women is 37,75±8,2. Enhanced vaginal secretion had 87,09% (N-120), painful coitus 61,29% (N-76), pain in lesser pelvis 52,41% (N-65) and abnormal vaginal bleeding 28,22% (N-35). Erosion of cervix had 14% (N-7) of women with LSIL. After cryotherapy, enhanced vaginal secretion remained in 21,77% (N-27) of women, painful coitus remained in 8,06% (N-10), pain in lesser pelvis remained in 5,6% (N-7) and abnormal vaginal bleeding in 6,4% (N-8). Four weeks after cryotherapy, complete epithelisation of cervix was in 87,90% (N-109) and after six weeks in 93,54% (N-116) of examined women. LSIL was eliminated in 92% (N-46) of women after cryotherapy and in 8% (N-4) results remained the same. Conclusion: Cryotherapy is successful method of elimination of cervical erosion, LSIL and pains with enhanced vaginal secretion.
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Affiliation(s)
- Mahira Jahic
- Private Gynecology Ordination ,,Dr Mahira Jahic" Tuzla, Bosnia and Herzegovina.,Faculty of Medicine, University of Tuzla, Tuzla, Bosni and Herzegovina
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Junior JE, Giraldo PC, Gonçalves AKS, do Amaral RLG, Linhares IM. Uterine cervical ectopy during reproductive age: cytological and microbiological findings. Diagn Cytopathol 2013; 42:401-4. [PMID: 24166971 DOI: 10.1002/dc.23053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 06/15/2013] [Accepted: 09/03/2013] [Indexed: 11/08/2022]
Abstract
Cervical ectopy is common in adolescents, pregnant women, and those taking high doses of estrogen-containing contraceptives. The majority of cases have spontaneous reversion, but some cases can be persistent. Studies suggested that the adequacy of a Pap smear could be affected and there is an increased risk cervical infections. This study is a cross-sectional study conducted from December 2009 to February 2011 with 457 women with cervical ectopy and 736 without ectopy. Cervical samples were collected in vials for analysis by ThinPrep cytology (Hologic, Marlborough, MA). The Mann-Whitney test and Fisher's exact test (95% CI) were applied. The study was approved by the ethics committee of the Federal University of Ceará. The mean ages of the study group and control group were 28.7 (±14.8) and 33.6 (±7.5) years old, respectively (P < 0.0001). Negative diagnosis for malignancy and intraepithelial lesion was present in 399 (87%) cases and 705 (96%) in the study and control groups, respectively (P < 0.0001). Shift in the flora suggestive of bacterial vaginosis (BV) was observed more frequently in the study group: 74 (16.2%) than in the control group: 86(11.7%) (P = 0.017). The differences among the other morphotypes showed no significance. The smears were atypical in 12.7% (58/457) of the patients from the study group and in 4.2% (31/736) in the control group (P < 0.001; RR = 3 [2.033-4.712]). The association between ectopy and inflammatory cytology, the presence of the shift in the flora suggestive of BV and cytological atypia is evident.
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Affiliation(s)
- José Eleutério Junior
- Maternal and Child Health Department, Federal University of Ceará, Fortaleza, Brazil
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Bayram A, Erkılıç S, Balat Ö, Ekşi F, Uğur MG, Öztürk E, Kaya G. Prevalence and genotype distribution of human papillomavirus in non-neoplastic cervical tissue lesion: Cervical erosion. J Med Virol 2011; 83:1997-2003. [DOI: 10.1002/jmv.22218] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hashmi S, Begum W, Sultana A. Efficacy of Sphaeranthus indicus and cream of Lawsonia inermis in cervical erosion with cervicitis. Eur J Integr Med 2011. [DOI: 10.1016/j.eujim.2011.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Li S, Meng YH, Ting H, Shen J, Ma D. Clinical significance of human papilloma virus infection in the cervical lesions. ACTA ACUST UNITED AC 2010; 4:264-70. [DOI: 10.1007/s11684-010-0094-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Accepted: 05/20/2010] [Indexed: 11/29/2022]
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Datta P, Bhatla N, Dar L, Patro AR, Gulati A, Kriplani A, Singh N. Prevalence of human papillomavirus infection among young women in North India. Cancer Epidemiol 2010; 34:157-61. [PMID: 20153993 DOI: 10.1016/j.canep.2009.12.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2009] [Revised: 12/22/2009] [Accepted: 12/22/2009] [Indexed: 11/16/2022]
Abstract
BACKGROUND The number of women infected with human papillomavirus (HPV) and the distribution of the HPV genotypes vary across populations and with age. OBJECTIVE To determine the prevalence and genotype distribution of HPV in young married women aged 16-24 years. METHODS 1300 women residing in an urban slum in Delhi donated samples of exfoliated cervical cells that were collected by the Digene((R)) kit and tested for the presence of HPV DNA by two techniques in parallel, i.e., PCR using PGMY consensus primers for all HPV types and the Digene HPV test (Hybrid Capture 2 (HC2) Probe B for high-risk (hr) types. Genotyping was done on all HPV positive samples using the Roche reverse line blot assay. RESULTS HPV infection was detected in 91/1300 (7%) samples by PCR and 110/1300 (8.4%) samples by HC2. Genotyping identified 20 high-risk and 11 low-risk types. HPV16 was the commonest high-risk type (3%) followed by HPV52 (1.2%) and HPV51 (0.8%). Among low-risk types, HPV62 was the commonest (0.8%), followed by HPV84 and HPV89 (0.5% each). Multiple infections were found in 3% of the HPV positive samples. CONCLUSION A wide spectrum of HPV genotypes is seen in this young population. Knowledge about HPV types prevalent in communities in different regions of India would be useful in devising the optimum strategy for cervical cancer prevention.
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Affiliation(s)
- Palika Datta
- Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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Bhatla N, Lal N, Bao YP, Ng T, Qiao YL. A meta-analysis of human papillomavirus type-distribution in women from South Asia: Implications for vaccination. Vaccine 2008; 26:2811-7. [DOI: 10.1016/j.vaccine.2008.03.047] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2008] [Revised: 03/18/2008] [Accepted: 03/19/2008] [Indexed: 10/22/2022]
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Machado Junior LC, Dalmaso ASW, Carvalho HBD. Evidence for benefits from treating cervical ectopy: literature review. SAO PAULO MED J 2008; 126:132-9. [PMID: 18553039 DOI: 10.1590/s1516-31802008000200014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2007] [Accepted: 03/07/2008] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND PURPOSE Uterine cervical ectopy (cervical erosion) is today considered to be a physiological condition, but there still seems to be a strong tendency towards treating it. The purpose of this study was to review the medical literature for evidence regarding benefits from treating cervical ectopy. METHODS The following databases were reviewed: Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica Database (Embase), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) and Cochrane Library databases. In addition, six medical textbooks were consulted. RESULTS The review showed that: 1) there is probably an association between ectopy and higher risk of Chlamydia trachomatis, human papillomavirus and human immunodeficiency virus infection; 4) there is probably an association between ectopy and cervical intraepithelial neoplasia; 5) there is an association between ectopy and mucous discharge and nocturia; and 6) there is no evidence of an association between ectopy and cervical cancer, or of protection against cervical cancer associated with ectopy treatment. CONCLUSIONS 1) No data were found in the medical literature to support routine treatment for ectopy; 2) Treatment could be recommended for symptom relief, but more symptoms are attributed to ectopy than could be demonstrated in a controlled study; 3) Further studies to test the hypothesis of protection against cervical cancer associated with treatment are necessary.
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Affiliation(s)
- Luís Carlos Machado Junior
- Centro de Saúde Escola Samuel Barnsley Pessoa, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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Bhattacharya P, Sengupta S. Predisposition to HPV16/18-related cervical cancer because of proline homozygosity at codon 72 of p53 among Indian women is influenced by HLA-B*07 and homozygosity of HLA-DQB1*03. ACTA ACUST UNITED AC 2007; 70:283-93. [PMID: 17767549 DOI: 10.1111/j.1399-0039.2007.00894.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study was undertaken to examine whether predisposition to human papillomavirus (HPV)16/18-related cervical cancer (CaCx) because of p53 proline homozygosity (Pro72Pro) among Indian women was mediated singly or jointly with immunogenetic risk factors such as HLA-B*07 or homozygosity of HLA-DQB1*03. Molecular detection of all three genetic factors was performed by polymerase chain reaction-restriction fragment length polymorphism using DNA from (i) 114 CaCx samples (78 HPV16/18 positive) and (ii) 195 cytologically normal cervical scrapes (116 HPV-negative and 79 HPV16/18-positive samples). Multiple logistic regression analyses were performed to examine independent effects of the three factors and to determine age-adjusted odds ratio (OR) [95% confidence interval (CI)] and P-values. HLA-B*07 was observed to be significantly associated with HPV16/18 infection in asymptomatic controls (OR(age-adjusted) = 4.73; 95% CI: 1.55-14.45; P = 0.006) and CaCx (OR(age-adjusted) = 6.14; 95% CI: 2.15-17.53; P < 0.001) in this enhanced sample set of CaCx cases. There was a lack of association between HLA-B*07 and HLA-DQB1*03 in our study samples. The association of p53Pro72Pro with CaCx was non-significant in the absence of HLA-B*07 in HPV16/18-positive women. In this group, prevalence of p53Pro72Pro and HLA-B*07 together was significantly higher (7.0%) among CaCx cases (OR(age-adjusted) = 14.05; 95% CI: 1.11-177.30; P = 0.04), compared with controls (1.3%) lacking both factors. HLA-DQB1*03 homozygosity (OR(age-adjusted) = 4.75; 95% CI: 1.17-19.30; P = 0.03) or p53Pro72Pro (OR(age-adjusted) = 5.84; 95% CI: 1.18-28.99; P = 0.03) was found to be significantly associated with CaCx, each in the absence of the other in this group but not when present jointly in contrast to those lacking both factors (P = 0.214). Thus, modulation of p53Pro72Pro-mediated susceptibility to CaCx by immunogenetic factors could possibly be mediated through cross talk between HPV16/18-induced immune evasion and cell transformation.
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Affiliation(s)
- P Bhattacharya
- Human Genetics Unit, Indian Statistical Institute, 203 B.T. Road, Kolkata 700 108, India
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Laikangbam P, Sengupta S, Bhattacharya P, Duttagupta C, Dhabali Singh T, Verma Y, Roy S, Das R, Mukhopadhyay S. A comparative profile of the prevalence and age distribution of human papillomavirus type 16/18 infections among three states of India with focus on northeast India. Int J Gynecol Cancer 2007; 17:107-17. [PMID: 17291240 DOI: 10.1111/j.1525-1438.2007.00827.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Human papillomavirus (HPV) DNA in cervical scrape samples of married women from Manipur (n= 692) and Sikkim (n= 415) in northeast India was determined and compared with that of women from West Bengal (n= 1112) in eastern India by polymerase chain reaction. HPV prevalence was lower in Manipur (7.4%) than in Sikkim (12.5%), which was closely followed by West Bengal (12.9%). HPV18 was predominant in Manipur (2.03%) and strikingly lower (0.2%) in Sikkim and West Bengal (0.9%), while the reverse was true for HPV16. The proportion of HPV16/18 infections in Manipur (3.3%, 22/672) and Sikkim (3.89%, 14/359) were comparable and significantly lower compared to that in West Bengal (7.8%, 79/1007) among women having normal cervical cytology. Such prevalence was similar among all age groups in Manipur: increased with age for women in Sikkim and dropped with age for those in West Bengal similar to that reported previously. At age < or =30 years, HPV16/18 prevalence in Manipur (3.3%) and Sikkim (2.5%) was comparable but was significantly lower (P < 0.05) in contrast to that in West Bengal (8.8%). Among abnormal cytologic lesions, HPV16/18 infections were significantly higher than in normals (P= 0.000) both in Sikkim (14.3%) and West Bengal (20.9%) and absent in Manipur. Such prevalence was noted among women in Sikkim aged >30 years and equally among those in West Bengal aged < or =30 or >30 years. Thus, women from northeast India, particularly from Manipur, appear less susceptible to HPV16/18 infection and related cervical lesions compared to those from West Bengal, where such proneness was prominently evident at age < or =30 years.
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Affiliation(s)
- P Laikangbam
- Human Genetics Unit, Indian Statistical Institute, 203 B.T. Road, Kolkata 700-108, India
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Bhattacharya P, Sengupta S. Lack of evidence that proline homozygosity at codon 72 of p53 and rare arginine allele at codon 31 of p21, jointly mediate cervical cancer susceptibility among Indian women. Gynecol Oncol 2005; 99:176-82. [PMID: 16054204 DOI: 10.1016/j.ygyno.2005.06.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2004] [Revised: 05/17/2005] [Accepted: 06/06/2005] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The objective of this study was to identify whether variants of p53Arg72Pro and p21Ser31Arg were associated with increased risk for cervical cancer (CaCx), either independently or jointly, among Indian women. METHODS Genotyping was done by PCR-RFLP using DNA from (i) 120 cervical biopsy tissues of squamous cell carcinoma of the cervix (of which 82 were HPV16/18 positive), and (ii) a total of 205 cytologically normal cervical scrapes (121 HPV-negative and 84 HPV16/18-positive samples, considered as discreet groups). Multiple logistic regression analyses were performed to examine additive or interactive effects of the two factors and for determining age-adjusted OR (95% CI) and P values. RESULTS The observed association of proline homozygosity at codon 72 of p53 with CaCx infection (Bhattacharya, P., Duttagupta, C., Sengupta, S. 2002.Proline homozygosity in codon 72 of p53: A risk genotype for Human Papillomavirus related cervical cancer in Indian women. Cancer Lett 188: 207-211) was retained among Indian women harboring HPV16/18 (OR(age-adjusted) = 3.76; 95% CI = 1.03-13.80; P = 0.04). Significant independent association was evident between the p21 arginine allele (rare allele with frequency of 0.1) at codon 31 and CaCx, compared to HPV-negative cytologically normal controls (OR(age-adjusted) = 2.01; 95% CI = 1.00-4.06; P = 0.05). The two risk factors jointly failed to show statistical interaction towards susceptibility to CaCx. The p21 arginine allele was significantly associated with CaCx in the p53 proline non-homozygous group of subjects (OR(age-adjusted) = 2.68; 95% CI: 1.21-5.91; P = 0.01), and specifically in the p53 heterozygous group (OR(age-adjusted) = 2.91; 95% CI = 1.12-7.56; P = 0.03). CONCLUSIONS p53 and p21 act in series in mediating cell cycle arrest. However, the two risk factors, p53 proline homozygosity and p21 arginine allele, although part of a common causal pathway, appear to act in a mutually exclusive manner.
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Affiliation(s)
- Paramita Bhattacharya
- Human Genetics Unit, Indian Statistical Institute, 203 B.T. Road, Kolkata 700 108, India
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Bhattacharjee B, Sengupta S. HPV16 E2 gene disruption and polymorphisms of E2 and LCR: some significant associations with cervical cancer in Indian women. Gynecol Oncol 2005; 100:372-8. [PMID: 16246404 DOI: 10.1016/j.ygyno.2005.09.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2005] [Revised: 08/24/2005] [Accepted: 09/06/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVES We evaluated the status of the HPV16 E2 gene (disrupted or intact), nucleotide sequence alterations within intact E2 genes and LCR of HPV16 isolates in a group of CaCx cases (invasive squamous cell carcinomas, n = 81) and population controls (normal cervical scrapes, n = 27) from Indian women. METHODS E2 disruption was detected by amplifying the entire E2 gene with single set of primers, while overlapping primers were used to determine if any particular region got selectively disrupted. Nucleotide variations in E2 and LCR were analyzed by PCR amplification followed by bi-directional sequencing. The associations between the viral factors and CaCx were analyzed using Fisher's Exact or Chi-squared test and interpreted as OR (95% CI) and P values. RESULTS E2 disruption was significantly higher among the cases [3.38 (1.07-10.72); P = 0.02], which was maximum in the region between nucleotides 3650 and 3872 (DNA-binding region). The European (E) variant was found to be the prevalent subgroup (87.76% among cases and 96.30% among the controls), and the remaining samples were Asian-American variants. Among the E subgroup, variation at position 7450 (T > C) within the E2-binding site-IV was found to be significantly higher among the E2 undisrupted cases (21/37; 56.76%), compared to controls (5/18; 27.78%) [3.41 (1.01-11.55); P = 0.03]. CONCLUSIONS Besides HPV16 E2 disruption, LCR 7450T > C variation within undisrupted E2 of E subgroup appears to be a major factor contributing to the risk of CaCx development in Indian women. Furthermore, polymorphisms in the E2 gene of HPV16 may not be significant for disease risk.
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Affiliation(s)
- Bornali Bhattacharjee
- Human Genetics Unit, Indian Statistical Institute, 203, B.T. Road, Kolkata 700108, India
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Duttagupta C, Sengupta S, Roy M, Sengupta D, Bhattacharya P, Laikangbam P, Roy S, Ghosh S, Das R. Are Muslim women less susceptible to oncogenic human papillomavirus infection? A study from rural eastern India. Int J Gynecol Cancer 2004; 14:293-303. [PMID: 15086729 DOI: 10.1111/j.1048-891x.2004.014213.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Muslim women are known to have lower incidences of cervical cancer and/or human papillomavirus (HPV) infection. Here we aim to determine any association that may be present between the oncogenic HPV16/18 infections and abnormal cytological lesions along with demographic and other attributes among Indian Muslim women (n = 478) and compare with the neighboring Hindus (n = 534) from a prospective cohort study. Agewise distribution of both subject-groups is similar. HPV16/18 infection is present in 9.6% Muslims and 7.5% Hindu women. Jointly atypical cells of undetermined significance (a typical cells of undetermined significance) and HPV16/18 are present in seven Muslim and two Hindu women. No high squamous intraepithelial lesions or cervical cancer is detected at the baseline. HPV16/18 infections show trends that varied with age, a nonlinear trend among Muslim women. In Hindu women the prevalence is highest at age < or =24 years, which linearly drops with increasing age. Abnormal cytology increases significantly in both religion-groups with increasing age. The data show that these Indian Muslim women are equally susceptible to HPV16/18 infection and for the development of abnormal cytology. There is a paucity in epidemiological data, which justifies the need to screen women of all religions for cervical cancer (that includes oncogenic HPV testing).
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Affiliation(s)
- C Duttagupta
- Biochemistry Unit, Indian Statistical Institute, 203 B.T. Road, Calcutta 700-108, West Bengal, India.
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