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Kultalahti H, Heinävaara S, Sarkeala T, Pankakoski M. Effect of Test History at Ages 50-64 on Later Cervical Cancer Risk: A Population-based Case-control Study. CANCER RESEARCH COMMUNICATIONS 2023; 3:1823-1829. [PMID: 37700796 PMCID: PMC10494786 DOI: 10.1158/2767-9764.crc-23-0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/26/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023]
Abstract
As life expectancy increases, the effectiveness of cervical cancer screening programs needs to be reassessed for the older population. We addressed the effect of test history in and outside organized screening at age 50-64 years on later cervical cancer risk. A case-control study was conducted by deriving 229 cases of 65-79 years old women with invasive cervical cancer in 2010-2019 from the Finnish Cancer Registry. Ten controls were matched for each case by birth year and hospital district. The effect of test uptake and abnormal results in 50-64 year olds on cancer risk was investigated using conditional logistic regression and adjusted for self-selection. Test uptake within the 50-64 years age group showed 75% lower odds of cervical cancer [adjusted OR (aOR) = 0.25; 95% confidence interval (95% CI), 0.18-0.35]. Untested women had 4.9 times higher odds than those tested with normal results (aOR = 4.86; 95% CI, 3.42-6.92). Having at least one abnormal test result increased the odds by 2.5 when compared with only normal results but showed lower odds when compared with untested women. The importance of testing is exhibited by the result showing a reduction of odds of cancer to one-fourth for those tested compared with untested. Similarly, receiving abnormal results was protective of cancer compared with having no tests highlighting the importance of proper follow-up. Therefore, screening history should be considered when further developing cervical cancer screening programs with special interest in non-attenders and those receiving abnormal results at older ages. Significance To our knowledge, this is the first study from Finnish data describing the effect of test history on later cervical cancer at older ages. Focusing on the cervical tests taken within the Finnish national screening program and outside it highlights the overall importance of having cervical tests and adds this study into the slowly increasing number of studies considering all cervical testing in Finland.
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Affiliation(s)
- Henric Kultalahti
- Finnish Cancer Registry, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sirpa Heinävaara
- Finnish Cancer Registry, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Maiju Pankakoski
- Finnish Cancer Registry, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Ashaka OS, Omoare AA, James AB, Adeyemi OO, Oladiji F, Adeniji KA, Okunade KS, Agbede OO. Prevalence and Risk Factors of Genital Human Papillomavirus Infections among Women in Lagos, Nigeria. Trop Med Infect Dis 2022; 7:386. [PMID: 36422937 PMCID: PMC9692597 DOI: 10.3390/tropicalmed7110386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 12/14/2023] Open
Abstract
Regional variations exist in HPV prevalence worldwide despite reports of high prevalence rates among African women. Limited data on genital HPV prevalence necessitated this study with the aim of determining the prevalence of genital HPV and associated risk factors among women in Lagos, Nigeria. Exfoliated cervical cells were collected with consent from 165 women using a cervical brush. Viral DNA was extracted and amplified by nested PCR using two sets of consensus primers (MY09/11 and GP5+/6+). An unconditional logistic regression model was used to identify predictors of HPV positivity. The HPV prevalence was 81.82% in all women and 87.59% in women with normal cytology. The risk of HPV infection was significantly increased among women who had a history of STI (odds ratio (OR) 3.94; 95% confidence interval (CI): 1.51-10.25, p = 0.005) while there was a significantly reduced risk of HPV infection among those who used condoms (odds ratio (OR) 3.94; 95% confidence interval (CI): 0.18-0.91, p = 0.03). The HPV prevalence observed shows an increased transmission of the virus in Lagos, Nigeria. Therefore, there is a need for intense public awareness and the implementation of early detection tests, treatment, and vaccination to prevent an increase in cervical cancer cases in Lagos, Nigeria.
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Affiliation(s)
| | - Adesuyi Ayodeji Omoare
- Department of Medical Microbiology and Parasitology, College of Health Sciences, University of Ilorin, Ilorin 240003, Nigeria
- National Reference Laboratory Department of Public Health Laboratory Services (PHLS), Nigeria Centre for Disease Control and Prevention (NCDC), Gaduwa, Abuja 900110, Nigeria
| | - Ayorinde Babatunde James
- Department of Biochemistry & Nutrition, Nigerian Institute of Medical Research, Lagos 100001, Nigeria
| | - Oluwapelumi Olufemi Adeyemi
- Department of Medical Microbiology and Parasitology, College of Health Sciences, University of Ilorin, Ilorin 240003, Nigeria
| | - Femi Oladiji
- Department of Epidemiology and Community Health, University of Ilorin, Ilorin 240003, Nigeria
| | - Kayode Adebamiji Adeniji
- Department of Morbid Anatomy and Histopathology, College of Health Sciences, University of Ilorin, Ilorin 240003, Nigeria
| | | | - Olajide Olubunmi Agbede
- Department of Medical Microbiology and Parasitology, College of Health Sciences, University of Ilorin, Ilorin 240003, Nigeria
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Griffin M, Jaiswal J, Stults CB. Human Papillomavirus Vaccination Rates by Gender Identity and Sexual Orientation Among 18-44-Year-Olds in the U.S. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3079-3092. [PMID: 33942195 DOI: 10.1007/s10508-020-01900-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 11/22/2020] [Accepted: 12/03/2020] [Indexed: 06/12/2023]
Abstract
In the U.S., human papillomavirus (HPV) vaccination has been recommended for individuals up to age 26, although the vaccination is currently approved for all people up to the age of 45. This research sought to explore HPV vaccination disparities by age with subgroup analysis by gender identity and sexual orientation groups, as well as sociodemographic factors that may serve as barriers to or facilitators of vaccination. This study used data from the 2018 Behavioral Risk Factor Surveillance System. Only data for individuals who reported their gender identity, sexual orientation, and HPV vaccination status were included in the analytic sample (n = 7330). HPV vaccination rates for this sample were low, as only 18.2% (n = 1332) of the sample had received the HPV vaccination. These low rates of vaccination were similar across all subsamples: cisgender men (9.8%, n = 343), cisgender women (25.8%, n = 985), heterosexuals (17.5%, n = 1197), lesbian women or gay men (20.8%, n = 40), and bisexuals (30.8%, n = 95). In multivariable logistic regression models, younger participants (18-34) were more likely to report receiving the HPV vaccination across all subsamples. Further modeling indicated several common factors associated with higher odds of vaccination: living in a metropolitan area, having insurance coverage, and having at least one provider. Understanding vaccination disparities, as well as vaccination facilitators and barriers, is important to inform policy and program efforts. This is especially significant for adults between the ages of 35 and 44 who were excluded from the initial vaccination recommendations but are vulnerable due to changing cultural norms, including delayed marriage, nonmonogamous long-term relationships, and the ending of long-term partnerships.
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Affiliation(s)
- Marybec Griffin
- Rutgers University School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Newark, NJ, USA.
| | - Jessica Jaiswal
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Newark, NJ, USA
- Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA
| | - Christopher B Stults
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Newark, NJ, USA
- Department of Psychology, Baruch College, City University of New York, New York, NY, USA
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Chen ML, Kao WM, Huang JY, Hung YM, Wei JCC. Human papillomavirus infection associated with increased risk of new-onset psoriasis: a nationwide population-based cohort study. Int J Epidemiol 2021; 49:786-797. [PMID: 32176290 DOI: 10.1093/ije/dyaa027] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 01/30/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study investigated whether patients with a history of human papillomavirus (HPV) infection are at increased risk of developing psoriasis. METHODS We enrolled 66 274 patients with HPV infection between 1997 and 2013 from the Taiwan National Health Insurance Research Database, and compared them with control individuals who had never been diagnosed with HPV infection (at a 1:4 ratio matched by age, sex and index year) in relation to the risk of developing psoriasis. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), with the control group as reference. RESULTS The adjusted hazard ratio (aHR) was 1.177 (95% CI, 1.010-1.373) after adjusting for demographic characteristics, comorbidities, dermatology-related outpatient visits and medications. The HPV group had an increased risk of psoriasis compared with the control group in all of the different age groups. The P-value for interaction between age and exposure of HPV is 0.009 in our sub-group analysis. CONCLUSIONS A higher risk of psoriasis was found after HPV infection, and age acted as an effect modifier between the HPV infection and risk of psoriasis.
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Affiliation(s)
- Ming-Li Chen
- School of Medicine, Department of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Wei-Ming Kao
- School of Medicine, Department of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University, Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yao-Min Hung
- Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan.,School of Medicine, Department of Medicine, National Yang Ming University, Taipei, Taiwan.,Department of Senior Citizen Service Management, Yuhing Junior College of Health Care and Management, Kaohsiung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Rheumatology, BenQ Medical Center, Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Taiwan.,Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Clark M, Jembere N, Wang L, Kupets R. Survival of Older Women With Cervical Cancer Based on Screening History. J Low Genit Tract Dis 2021; 25:9-14. [PMID: 33347044 DOI: 10.1097/lgt.0000000000000582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A population-level retrospective cohort study was conducted to determine the influence of cervical screening history on the survival from cervical cancer in women 50 years or older. METHODS The study included women diagnosed with invasive cervical cancer in Ontario, Canada, between 2005 and 2012, who were followed for at least 4 years. Screening history was observed for the 5 years before diagnosis. Health care administrative databases were linked to determine demographic, affiliation with primary care physicians, stage (available 2010-2012), treatment, and survival data. Kaplan-Meier and multivariate analyses were carried out to evaluate the impact of cervical screening on overall survival (OS). RESULTS There were eligible 1,422 women diagnosed with invasive cervical cancer between 2005 and 2012 of whom 566 had been screened within the 5 years before diagnosis. There were 856 women who did not undergo screening within the 5 years before diagnosis. Unscreened women were more likely to present with locally advanced disease (69.3%) compared with the screened women (42.9%). Four-year OS was significantly greater in the screened group (79.9% vs 58.2%). In our univariate analysis, screening was significantly related to survival (hazard ratio = 2.1, p < .01). In our multivariate analysis after adjusting for age, treatment, affiliation with a primary care physician, and income, screening was still significantly associated with improved survival (hazard ratio = 1.5, p < .01). CONCLUSIONS Our results demonstrate a survival benefit to screening in women 50 years or older who are diagnosed with cervical cancer. Screening participation must be encouraged in women older than 50 years as rates decline in this age group.
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Affiliation(s)
- Mitchell Clark
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
| | | | - Li Wang
- Cancer Care Ontario, Toronto, Ontario, Canada
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Hemmat N, Bannazadeh Baghi H. Association of human papillomavirus infection and inflammation in cervical cancer. Pathog Dis 2020; 77:5558235. [PMID: 31504464 DOI: 10.1093/femspd/ftz048] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 09/01/2019] [Indexed: 12/11/2022] Open
Abstract
Human papillomavirus (HPV) associated cancers, and in particular cervical cancer, are considered to be directly stimulated by HPV oncogenes. Alternatively, these types of cancers could also be indirectly stimulated by HPV-induced chronic inflammations, which in turn are also caused by HPV oncogenes activity. Chronic inflammation is associated with repeated tissue injury and development of mutations in the vital tumor suppressor genes. Thus, it is important to understand that the persistent HPV infection and its associated chronic inflammation is responsible for the progression of HPV-induced cancers. HPV E5, E6 and E7 could upregulate the expression of cyclooxygenase (COX)-2 and prostaglandin (PG) E2 followed by the activation of the COX-PG pathway. This pathway is assumed to be the main cause of HPV-induced inflammation. Additionally, HPV oncogenes could have an impact on the upregulation of pro-inflammatory cytokines in HPV-positive patients. The upregulation of such cytokines accelerates the incidence of inflammation following HPV infection. Other factors such as microRNAs, which are involved in the inflammation pathways and aging, give rise to the increased level of pro-inflammatory cytokines and could also be responsible for the acceleration of HPV-induced inflammation and consequent cervical cancer. In this review, the exact roles of HPV oncogenes in the occurrence of inflammation in cervical tissue, and the effects of other factors in this event are evaluated.
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Affiliation(s)
- Nima Hemmat
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Drug Applied Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Bannazadeh Baghi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Andersen B, Christensen BS, Christensen J, Ejersbo D, Heje HN, Jochumsen KM, Johansen T, Larsen LG, Lynge E, Serizawa R, Viborg PH, Waldstrøm M. HPV-prevalence in elderly women in Denmark. Gynecol Oncol 2019; 154:118-123. [DOI: 10.1016/j.ygyno.2019.04.680] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 11/12/2022]
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8
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Alzheimer's disease might depend on enabling pathogens which do not necessarily cross the blood-brain barrier. Med Hypotheses 2019; 125:129-136. [PMID: 30902141 DOI: 10.1016/j.mehy.2019.02.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 02/20/2019] [Indexed: 01/04/2023]
Abstract
The development of Alzheimer's Disease (AD) might reflect, in its acquired aspects, a cooperative pathogenesis whereby infectious enablers which do not necessarily cross the blood-brain barrier augment the invasive properties of a less virulent organism, thus enabling it to infect the brain. An example interaction is described which involves Chlamydia species, Human papillomavirus (HPV), microbiota, and yeast, where yeast is a pathogen of low virulence which crosses the blood-brain barrier. The cooperative pathogenesis begins at the mucosal epithelium. Infection by Chlamydia, HPV, or dysbiosis of commensal bacteria disrupts the integrity of the mucosal epithelium, thereby allowing colonizing yeast to penetrate the epithelial barrier and enter into the bloodstream. Chlamydia and enabling commensals promote insulin resistance, which provides yeast with glucose and also sets the stage for accumulation of amyloid beta protein (ABP). Meanwhile, HPV-induced and hyperglycemia-induced immunological changes enable the spread of newly invasive yeast to the brain, where the release of inflammatory cytokines in response to yeast promotes production of ABP. Chlamydia also cross reacts with Candida species, which may stimulate further brain inflammation in response to Candida and may augment production of ABP thereby The yeast's less virulent origins, coupled with immune modulation by enablers, might explain why AD as a model of infectious encephalitis is always slow and insidious rather than occasionally febrile, accompanied by seizures, or marked by signs of meningeal inflammation.
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Mirbahari SG, Sadeghi M. The Prevalence of Genus Alpha Human Papillomavirus in Women with Uterine Cervical Infection and/or Inflammation in Western Iran. Mater Sociomed 2018; 30:113-117. [PMID: 30061800 PMCID: PMC6029900 DOI: 10.5455/msm.2018.30.113-117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Introduction: Human papillomavirus (HPV) infection is strongly associated with risk of cervical cancer and genital warts. Aim: The study aimed to report the prevalence of genus alpha human papillomavirus (HPV) types in women with cervical infection and/or inflammatory in Western Iran. Materials and Methods: In a cross-sectional study, 435 women were clinically diagnosed with cervical infections. The method of HPVs detection was polymerase chain reaction (PCR). The majority of patients (304 patients) did Pap smear based on liquid-based specimens. Results: Out of 435 patients, 150 patients (34.5%) had HPV positivity that the prevalence of high-risk HPVs was 52.7%. Out of 76 patients with Pap smear positivity, 68.4% had atypical squamous cells of undetermined significance cytology class and 31.6% had low-grade squamous intraepithelial lesion cytology class. The most prevalence rate of HPV was in age ≤30 years. HPV 16 and HPV 56 were the most prevalence rate among high-risk HPVs. Overall HPV alpha-10 (59%) and HPV alpha-9 (32.2%) had the most prevalence rate. Conclusions: Among high-risk HPVs, HPV 16 was the most common HPV detected in our population with a very low prevalence of HPV 18. In addition, HPV 6 and then HPV 11 had the most prevalence rate in the women with uterine cervix (cervical) infection among low-risk HPVs.
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Affiliation(s)
- Seyed Ghasem Mirbahari
- Department of Pathology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
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10
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Prevalence and correlates of vaginal estrogenization in postmenopausal women in the United States. Menopause 2018; 24:536-545. [PMID: 27898651 DOI: 10.1097/gme.0000000000000787] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This work aims to establish current population-based vaginal estrogenization norms for postmenopausal US women. METHODS Using a US national probability sample of 868 postmenopausal women ages 57 to 85 years (mean age 67.6 ± 0.3 y, 21.6 ± 0.5 y since menopause), we calculated the epithelial maturation value (MV) generated from self-collected vaginal specimens and compared findings with historical clinical data. Linear and logistic regressions were used to describe the relationship between vaginal estrogenization and sociodemographic, physical, gynecologic, and sexual characteristics. RESULTS Among postmenopausal women, mean MV was 46.6 ± 0.8 (SD 17.4, range 2.5-100) and stable across age groups. In every age group, vaginal estrogenization was higher among postmenopausal nonusers of hormone therapy (HT) in the 2005-2006 US cohort than reported for the 1960s Canadian clinical cohort. MV was also higher among women who used postmenopausal HT in the prior 12 months compared with those who did not (55.1 ± 1.2 vs 44.4 ± 0.9, P < 0.001). In multivariate analyses, HT use, obesity and African American race were each independently associated with higher MV. Overall, MV was not associated with sexual activity, but low MV was associated with vaginal dryness during intercourse among sexually active women. CONCLUSIONS Compared to 1960s clinical data, current population estimates revealed higher vaginal estrogenization across all age groups and no decline with age. The strongest independent correlates of vaginal estrogenization in postmenopausal US women were current HT use, obesity, and African American race. Postmenopause, half of all women exhibit low vaginal estrogenization.
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Machida H, Blake EA, Eckhardt SE, Takiuchi T, Grubbs BH, Mikami M, Roman LD, Matsuo K. Trends in single women with malignancy of the uterine cervix in United States. J Gynecol Oncol 2017; 29:e24. [PMID: 29400017 PMCID: PMC5823985 DOI: 10.3802/jgo.2018.29.e24] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 12/05/2017] [Accepted: 12/08/2017] [Indexed: 11/30/2022] Open
Abstract
Objective To examine trends and characteristics of single women with malignancy of the uterine cervix. Methods This is a retrospective observational study examining the United States population-based tumor registry (the Surveillance, Epidemiology, and End Results program). Time-specific trends in single marital status were examined in 3,294,208 women among 12 common female malignancies including 87,151 women with uterine cervical malignancy between 1973 and 2013. Results While the proportion of single women in the majority of malignancies increased during the study time, the proportion of single women with cervical malignancy significantly increased more than in other malignancies (29.3% in 2013 from 6.3% in 1973). There was a surge in the proportion of single women with cervical malignancy starting in the early 1990s, exhibiting the largest annual percentage rate change (APC) among all examined malignancies (1.8%; 95% confidence interval [CI]=1.6, 2.0; p<0.001). There was a significant decrease in the proportion of women aged <40 years with cervical malignancy between 1989 and 2013 (APC, −1.2%; 95% CI=−1.4, −1.0; p<0.001). However, when stratified by age, the proportion of single women aged ≥40 years increased significantly during the time (APC, 2.7%; 95% CI=2.3, 3.2; p<0.001) but did not in those who were <40 years (APC, 0.1%; 95% CI=−0.7, 0.6; p=0.850). Conclusion The proportion of single women with malignancy of the uterine cervix has significantly increased in the past 4 decades. This increase was most dramatic in single women aged ≥40 years. Improving screening strategies in single women aged ≥40 years may help reduce the incidence of this malignancy.
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Affiliation(s)
- Hiroko Machida
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Erin A Blake
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Sarah E Eckhardt
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Tsuyoshi Takiuchi
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Brendan H Grubbs
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Japan
| | - Lynda D Roman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
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Estimation of the prevalence and distribution of HPV genotypes and identification of related risk factors among Turkish women. Contemp Oncol (Pozn) 2017; 21:218-223. [PMID: 29180929 PMCID: PMC5701576 DOI: 10.5114/wo.2017.69591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/12/2017] [Indexed: 11/29/2022] Open
Abstract
Aim of the study The present study aims to estimate the prevalence and distribution of HPV genotypes and identify related risk factors among Turkish women. Material and methods 11 624 Turkish women attending our gynaecological clinic and expressing a desire for access to cervical cancer screening were assessed during the years 2014–2016. Cervical specimens were collected and transported using the HC2 HPV DNA Collection Device (consisting of a cervical brush and digene Specimen Transport Medium). Results Among these 11 624 individuals, positive HPV test results were obtained for 325 (2.79%), and negative results were observed for 11 299 (97.2%). The vast majority of patients were between the 3rd and 5th decades and the mean age of the patients was 44 ±9.12 (range 27–66). Among the HPV-positive women, 205 were positive for a single HPV type (205/325 = 63.1% of HPV infections; 205/11624 = 1.76% of all samples) and 120 were positive for multiple types (120/325 = 36.9% of HPV infections; 120/11624 = 1.03% of all samples). The four most prevalent high-risk types were HPV 16, 31, 51 and 52, with frequencies of 11.25%, 7.83%, 6.06% and 3.16%, respectively. Conclusions There appears to be geographic variation in the distribution of HPV genotypes. In this study, the four most prevalent high-risk types were HPV 16, 31, 51 and 52, with frequencies of 11.25%, 7.83%, 6.06% and 3.16%, respectively.
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Luquain A, Belglaiaa E, Guenat D, Vrecko S, Riethmuller D, Valmary-Degano S, Bedgedjian I, Chouham S, Prétet JL, Mougin C. High prevalence of abnormal cervical smears in a hospital cohort of French women beyond the upper age limit screening program. Prev Med 2015; 81:157-62. [PMID: 26348451 DOI: 10.1016/j.ypmed.2015.08.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 08/27/2015] [Accepted: 08/31/2015] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To determine the prevalence of cytological abnormalities and high risk Human PapillomaVirus (hrHPV) in cervical smears from French women aged over 65 years who attended the referent Gynecology Clinic of the Besançon University Hospital. METHODS Between 2002 and 2012, 796 French women aged 66-99 years were cotested for cytology and hrHPV by Hybrid Capture 2 (hc2). hc2-positive cases were subjected to real time PCR for specific HPV 16/18/45 genotyping. Women with normal Pap smears and positive for hrHPV were followed-up every 12 months. RESULTS Cytological abnormalities were detected in more than 30% of women and cervical cancers (CC) in 2.9% of women. Benign lesions were more frequent in women aged 66-75 years while (pre)-malignant lesions were preferentially found in women over 76. The prevalence of hrHPV was 22.7%. HPV 16 was the most frequent (23.8%), followed by HPV 45 (7.7%) and HPV 18 (3.9%). The rate of hrHPV increased with the lesion severity and HPV 16 was identified in 50% of CC. Among the followed-up women, those who developed CIN3 were HPV16 positive at study entry. CONCLUSION The study provides important estimates of the prevalence of cervical abnormalities and hrHPV positivity in a French hospital based-population over 65. Findings suggest to consider this high risk population in regards to cervical cancer.
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Affiliation(s)
- Alexandra Luquain
- Centre Hospitalier Régional Universitaire de Besançon, F-25000, France.
| | - Essaada Belglaiaa
- Laboratoire de Biologie Cellulaire et Génétique Moléculaire, Faculté des Sciences, Université Ibn Zohr, Agadir, Maroc; Université Bourgogne Franche-Comté, F-25000 Besançon, France; EA 3181, LabEx LipSTIC ANR-11-LABX-0021, FED4234, CIC-1431F-25000 Besançon, France.
| | - David Guenat
- Centre Hospitalier Régional Universitaire de Besançon, F-25000, France; Université Bourgogne Franche-Comté, F-25000 Besançon, France.
| | - Sindy Vrecko
- Université Bourgogne Franche-Comté, F-25000 Besançon, France.
| | - Didier Riethmuller
- Centre Hospitalier Régional Universitaire de Besançon, F-25000, France; Université Bourgogne Franche-Comté, F-25000 Besançon, France; EA 3181, LabEx LipSTIC ANR-11-LABX-0021, FED4234, CIC-1431F-25000 Besançon, France.
| | - Séverine Valmary-Degano
- Centre Hospitalier Régional Universitaire de Besançon, F-25000, France; Université Bourgogne Franche-Comté, F-25000 Besançon, France; EA 3181, LabEx LipSTIC ANR-11-LABX-0021, FED4234, CIC-1431F-25000 Besançon, France.
| | | | - Said Chouham
- Laboratoire de Biologie Cellulaire et Génétique Moléculaire, Faculté des Sciences, Université Ibn Zohr, Agadir, Maroc.
| | - Jean-Luc Prétet
- Centre Hospitalier Régional Universitaire de Besançon, F-25000, France; Université Bourgogne Franche-Comté, F-25000 Besançon, France; EA 3181, LabEx LipSTIC ANR-11-LABX-0021, FED4234, CIC-1431F-25000 Besançon, France.
| | - Christiane Mougin
- Centre Hospitalier Régional Universitaire de Besançon, F-25000, France; Université Bourgogne Franche-Comté, F-25000 Besançon, France; EA 3181, LabEx LipSTIC ANR-11-LABX-0021, FED4234, CIC-1431F-25000 Besançon, France.
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Thomason A, Capps N, Lefler L, Richard-Davis G. Factors Affecting Gynecologic and Sexual Assessment in Older Women: A Lesson for Primary Care Providers. Healthcare (Basel) 2015; 3:683-94. [PMID: 27417790 PMCID: PMC4939570 DOI: 10.3390/healthcare3030683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 07/19/2015] [Accepted: 08/07/2015] [Indexed: 11/17/2022] Open
Abstract
Guidelines for screening of cervical cancer and pelvic exams for older women have recently changed. These changes may have unexpected sequelae in women over 65 years of age. This manuscript provides a review of gynecologic screening recommendations for older women in the U.S. and potential ramifications of these recent changes. Peer reviewed guidelines from the American College of Obstetrics and Gynecology, U.S. Preventative Task Force Services, the American Cancer Society, The Centers for Disease Control, and multiple original research articles and reviews were reviewed for this manuscript. Women over 65 are at greatest risk to develop late stage diagnoses of cancers, pelvic organ disease, incontinence, and infections. Clinicians will need to acutely consider this fact when communicating and screening this population. We conclude that practitioners should be aware of the new guidelines and should consider including gynecologic health history and symptom analysis as part of annual exams in women of all ages.
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Affiliation(s)
- Ayasha Thomason
- College of Nursing, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 529, Little Rock, AR 72205, USA.
| | - Natalie Capps
- College of Nursing, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 529, Little Rock, AR 72205, USA.
| | - Leanne Lefler
- College of Nursing, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 529, Little Rock, AR 72205, USA.
| | - Gloria Richard-Davis
- College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 518, Little Rock, AR 72205, USA.
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O'Doherty K, Jaszczak A, Hoffmann JN, You HM, Kern DW, Pagel K, McPhillips J, Schumm LP, Dale W, Huang ES, McClintock MK. Survey field methods for expanded biospecimen and biomeasure collection in NSHAP Wave 2. J Gerontol B Psychol Sci Soc Sci 2014; 69 Suppl 2:S27-37. [PMID: 25360025 PMCID: PMC4303095 DOI: 10.1093/geronb/gbu045] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 03/31/2014] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES The National Social Life, Health, and Aging Project is a nationally representative, longitudinal survey of older adults. A main component is the collection of biomeasures to objectively assess physiological status relevant to psychosocial variables, aging conditions, and disease. Wave 2 added novel biomeasures, refined those collected in Wave 1, and provides a reference for the collection protocols and strategy common to the biomeasures. The effects of aging, gender, and their interaction are presented in the specific biomeasure papers included in this Special Issue. METHOD A transdisciplinary working group expanded the biomeasures collected to include physiological, genetic, anthropometric, functional, neuropsychological, and sensory measures, yielding 37 more than in Wave 1. All were designed for collection in respondents' homes by nonmedically trained field interviewers. RESULTS Both repeated and novel biomeasures were successful. Those in Wave 1 were refined to improve quality, and ensure consistency for longitudinal analysis. Four new biospecimens yielded 27 novel measures. During the interview, 19 biomeasures were recorded covering anthropometric, functional, neuropsychological, and sensory measures and actigraphy provided data on activity and sleep. DISCUSSION Improved field methods included in-home collection, temperature control, establishment of a central survey biomeasure laboratory, and shipping, all of which were crucial for successful collection by the field interviewers and accurate laboratory assay of the biomeasures (92.1% average co-operation rate and 97.3% average assay success rate). Developed for home interviews, these biomeasures are readily applicable to other surveys.
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Affiliation(s)
| | | | | | | | - David W Kern
- Institute for Mind and Biology, Department of Comparative Human Development
| | - Kristina Pagel
- Institute for Mind and Biology, Department of Comparative Human Development
| | | | | | - William Dale
- Department of Medicine, University of Chicago, Illinois
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16
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Levovitz C, Chen D, Ivansson E, Gyllensten U, Finnigan JP, Alshawish S, Zhang W, Schadt EE, Posner MR, Genden EM, Boffetta P, Sikora AG. TGFβ receptor 1: an immune susceptibility gene in HPV-associated cancer. Cancer Res 2014; 74:6833-44. [PMID: 25273091 DOI: 10.1158/0008-5472.can-14-0602-t] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Only a minority of those exposed to human papillomavirus (HPV) develop HPV-related cervical and oropharyngeal cancer. Because host immunity affects infection and progression to cancer, we tested the hypothesis that genetic variation in immune-related genes is a determinant of susceptibility to oropharyngeal cancer and other HPV-associated cancers by performing a multitier integrative computational analysis with oropharyngeal cancer data from a head and neck cancer genome-wide association study (GWAS). Independent analyses, including single-gene, gene-interconnectivity, protein-protein interaction, gene expression, and pathway analysis, identified immune genes and pathways significantly associated with oropharyngeal cancer. TGFβR1, which intersected all tiers of analysis and thus selected for validation, replicated significantly in the head and neck cancer GWAS limited to HPV-seropositive cases and an independent cervical cancer GWAS. The TGFβR1 containing p38-MAPK pathway was significantly associated with oropharyngeal cancer and cervical cancer, and TGFβR1 was overexpressed in oropharyngeal cancer, cervical cancer, and HPV(+) head and neck cancer tumors. These concordant analyses implicate TGFβR1 signaling as a process dysregulated across HPV-related cancers. This study demonstrates that genetic variation in immune-related genes is associated with susceptibility to oropharyngeal cancer and implicates TGFβR1/TGFβ signaling in the development of both oropharyngeal cancer and cervical cancer. Better understanding of the immunogenetic basis of susceptibility to HPV-associated cancers may provide insight into host/virus interactions and immune processes dysregulated in the minority of HPV-exposed individuals who progress to cancer.
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Affiliation(s)
- Chaya Levovitz
- The Icahn School of Medicine at Mount Sinai, New York, New York. Department of Immunology, Icahn School of Medicine at Mount Sinai, New York, New York. Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dan Chen
- SciLifeLab Uppsala, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden
| | - Emma Ivansson
- SciLifeLab Uppsala, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden
| | - Ulf Gyllensten
- SciLifeLab Uppsala, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden
| | - John P Finnigan
- The Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sara Alshawish
- The Icahn School of Medicine at Mount Sinai, New York, New York
| | - Weijia Zhang
- Mount Sinai Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Eric E Schadt
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York. Mount Sinai Institute for Genomics and Multiscale Biology, New York, New York
| | - Marshal R Posner
- The Icahn School of Medicine at Mount Sinai, New York, New York. Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Eric M Genden
- The Icahn School of Medicine at Mount Sinai, New York, New York. Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York. Department of Immunology, Genetics and Pathology, Tisch Cancer Institute, New York, New York
| | - Paolo Boffetta
- The Icahn School of Medicine at Mount Sinai, New York, New York. Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York. Department of Immunology, Genetics and Pathology, Tisch Cancer Institute, New York, New York
| | - Andrew G Sikora
- The Icahn School of Medicine at Mount Sinai, New York, New York. Department of Immunology, Icahn School of Medicine at Mount Sinai, New York, New York. Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York. Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York. Department of Immunology, Genetics and Pathology, Tisch Cancer Institute, New York, New York.
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Kaderli R, Schnüriger B, Brügger LE. The impact of smoking on HPV infection and the development of anogenital warts. Int J Colorectal Dis 2014; 29:899-908. [PMID: 24935346 DOI: 10.1007/s00384-014-1922-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2014] [Indexed: 02/04/2023]
Abstract
PURPOSE The worldwide prevalence of human papillomavirus (HPV) infection is estimated at 9-13 %. Persistent infection can lead to the development of malignant and nonmalignant diseases. Low-risk HPV types are mostly associated with benign lesions such as anogenital warts. In the present systematic review, we examined the impact of smoking on HPV infection and the development of anogenital warts, respectively. METHODS A systematic literature search was performed using MEDLINE database for peer-reviewed articles published from January 01, 1985 to November 30, 2013. Pooled rates of HPV prevalence were compared using the χ (2) test. RESULTS In both genders, smoking is associated with higher incidence and prevalence rates for HPV infection, whereas the latter responds to a dose-effect relationship. The overall HPV prevalence for smoking patients was 48.2 versus 37. 5 % for nonsmoking patients (p < 0.001) (odds ratio (OR) = 1.5, 95 % confidence interval (CI) 1.4-1.7). Smoking does also increase persistence rates for high-risk HPV infection, while this correlation is debatable for low-risk HPV. The incidence and recurrence rates of anogenital warts are significantly increased in smokers. CONCLUSIONS Most current data demonstrate an association between smoking, increased anogenital HPV infection, and development of anogenital warts. These data add to the long list of reasons for making smoking cessation a keystone of patient health.
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Affiliation(s)
- Reto Kaderli
- Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, 3010, Bern, Switzerland,
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Urinary incontinence, depression, and economic outcomes in a cohort of women between the ages of 54 and 65 years. Obstet Gynecol 2014; 123:822-7. [PMID: 24785611 DOI: 10.1097/aog.0000000000000186] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To estimate the association between urinary incontinence (UI) and probable depression, work disability, and workforce exit. METHODS The analytic sample consisted of 4,511 women enrolled in the population-based Health and Retirement Study cohort. The analysis baseline was 1996, the year that questions about UI were added to the survey instrument, and at which time study participants were 54-65 years of age. Women were followed-up with biennial interviews until 2010-2011. Outcomes of interest were onset of probable depression, work disability, and workforce exit. Urinary incontinence was specified in different ways based on questions about experience and frequency of urine loss. We fit Cox proportional hazards regression models to the data, adjusting the estimates for baseline sociodemographic and health status variables previously found to confound the association between UI and the outcomes of interest. RESULTS At baseline, 727 participants (survey-weighted prevalence, 16.6%; 95% confidence interval [CI] 15.4-18.0) reported any UI, of which 212 (survey-weighted prevalence, 29.2%; 95% CI 25.4-33.3) reported urine loss on more than 15 days in the past month; and 1,052 participants were categorized as having probable depression (survey-weighted prevalence, 21.6%; 95% CI 19.8-23.6). Urinary incontinence was associated with increased risks for probable depression (adjusted hazard ratio, 1.43; 95% CI 1.27-1.62) and work disability (adjusted hazard ratio, 1.21; 95% CI 1.01-1.45), but not workforce exit (adjusted hazard ratio, 1.06; 95% CI 0.93-1.21). CONCLUSION In a population-based cohort of women between ages 54 and 65 years, UI was associated with increased risks for probable depression and work disability. Improved diagnosis and management of UI may yield significant economic and psychosocial benefits.
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Reiter PL, Katz ML, Ruffin MT, Hade EM, DeGraffenreid CR, Patel DA, Paskett ED, Unger ER. HPV prevalence among women from Appalachia: results from the CARE project. PLoS One 2013; 8:e74276. [PMID: 24023700 PMCID: PMC3758277 DOI: 10.1371/journal.pone.0074276] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 07/29/2013] [Indexed: 01/23/2023] Open
Abstract
Background Cervical cancer incidence and mortality rates are high among women from Appalachia, yet data do not exist on human papillomavirus (HPV) prevalence among these women. We examined the prevalence of genital HPV among Appalachian women and identified correlates of HPV detection. Methods We report data from a case-control study conducted between January 2006 and December 2008 as part of the Community Awareness, Resources, and Education (CARE) Project. We examined HPV prevalence among 1116 women (278 women with abnormal Pap tests at study entry [cases], 838 women with normal Pap tests [controls]) from Appalachian Ohio. Analyses used multivariable logistic regression to identify correlates of HPV detection. Results The prevalence of HPV was 43.1% for any HPV type, 33.5% for high-risk HPV types, 23.4% for low-risk HPV types, and 12.5% for vaccine-preventable HPV types. Detection of any HPV type was more common among women who were ages 18–26 (OR = 2.09, 95% CI: 1.26–3.50), current smokers (OR = 1.86, 95% CI: 1.26–2.73), had at least five male sexual partners during their lifetime (OR = 2.28, 95% CI: 1.56–3.33), or had multiple male sexual partners during the last year (OR = 1.98, 95% CI: 1.25–3.14). Similar correlates were identified for detection of a high-risk HPV type. Conclusions HPV was prevalent among Appalachian women, with many women having a high-risk HPV type detected. Results may help explain the high cervical cancer rates observed among Appalachian women and can help inform future cervical cancer prevention efforts in this geographic region.
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Affiliation(s)
- Paul L. Reiter
- Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
- College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
| | - Mira L. Katz
- Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
- College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
| | - Mack T. Ruffin
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
- * E-mail:
| | - Erinn M. Hade
- Center for Biostatistics, The Ohio State University, Columbus, Ohio, United States of America
| | - Cecilia R. DeGraffenreid
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
| | - Divya A. Patel
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Electra D. Paskett
- Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
- College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
| | - Elizabeth R. Unger
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Bodelon C, Madeleine MM, Johnson LG, Du Q, Galloway DA, Malkki M, Petersdorf EW, Schwartz SM. Genetic variation in the TLR and NF-κB pathways and cervical and vulvar cancer risk: a population-based case-control study. Int J Cancer 2013; 134:437-44. [PMID: 23824834 DOI: 10.1002/ijc.28364] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 06/04/2013] [Accepted: 06/17/2013] [Indexed: 01/23/2023]
Abstract
Genital infection with the oncogenic human papillomavirus is the necessary cause of cervical cancer and of a large fraction of vulvar cancers. The toll-like receptor and the nuclear factor κB (NF-κB) signaling pathways have been implicated in inflammation, autoimmune disease and cancer, but whether common nucleotide variation in these pathways is associated with the risk of cervical and vulvar cancers has received little study. Using data from a population-based case-control study of cervical and vulvar cancers, we genotyped 205 single nucleotide polymorphisms (SNPs) in and around 32 candidate gene regions within these pathways. Gene-based analyses were used to estimate the associations between individual gene regions and the risk of cervical and vulvar cancers. Odds ratio (OR) and 95% confidence intervals (CI) were calculated to assess the risk of cervical and vulvar cancers for each SNP. p-Values were adjusted for multiple testing. A total of 876 cervical cancer cases, 517 vulvar cancer cases and 1,100 controls were included in the analysis. The TNF region was significantly associated with the risks of cervical cancer (gene-based p-value: 2.0 × 10(-4) ) and vulvar cancer (gene-based p-value: 1.0 × 10(-4) ). The rare allele (A) of SNP rs2239704 in the 5' UTR of the LTA gene was significantly associated with increased risks of cervical cancer (OR=1.31, 95% CI: 1.15-1.50; adjusted p-value: 0.013) and vulvar cancer (OR=1.51, 95% CI: 1.30-1.75; adjusted p-value: 1.9 × 10(-5) ). These findings add to the evidence of the importance of the immune system in the etiology of cervical and vulvar cancers.
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Affiliation(s)
- Clara Bodelon
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
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Bellinger JD, Brandt HM, Hardin JW, Bynum S, Sharpe PA, Jackson D. The role of family history of cancer on cervical cancer screening behavior in a population-based survey of women in the Southeastern United States. Womens Health Issues 2013; 23:e197-204. [PMID: 23722075 PMCID: PMC3700594 DOI: 10.1016/j.whi.2013.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 03/05/2013] [Accepted: 03/29/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Our objective was to determine the association of self-reported family history of cancer (FHC) on cervical cancer screening to inform a potential link with cancer preventive behaviors in a region with persistent cancer disparities. METHODS Self-reported FHC, Pap test behavior, and access to care were measured in a statewide population-based survey of human papillomavirus and cervical cancer (n = 918). Random-digit dial, computer-assisted telephone interviews were used to contact eligible respondents (adult [ages 18-70] women in South Carolina with landline telephones]. Logistic regression models were estimated using STATA 12. FINDINGS Although FHC+ was not predictive (odds ratio [OR], 1.17; 95% confidence interval [CI], 0.55-2.51), private health insurance (OR, 2.35; 95% confidence interval [CI], 1.15-4.81) and younger age (18-30 years: OR, 7.76; 95% CI, 1.91, 3.16) were associated with recent Pap test behavior. FHC and cervical cancer screening associations were not detected in the sample. CONCLUSIONS Findings suggest targeting older women with screening recommendations and providing available screening resources for underserved women.
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Affiliation(s)
- Jessica D. Bellinger
- Department of Health Services Policy and Management, South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 204, Columbia, SC 29210, Tel: (803) 251-6317, Fax: (803) 251-6399
| | - Heather M. Brandt
- Department of Health Promotion Education & Behavior, Arnold School of Public Health, University of South Carolina, 800 Sumter Street HESC 312A, Columbia, SC 29208; Tel: (803) 777-4561, Fax: (803) 777-6290
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Room 230, Columbia, SC 29208
| | - James W. Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, Biostatistics Collaborative Unit, University of South Carolina, 1600 Hampton Street, Suite 507, Columbia, SC 28208; Tel: (803) 777-0379, Fax: (803) 777-0391
| | - Shalanda Bynum
- Department of Preventive Medicine & Biometrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, Tel: (301) 295-1585; Fax: (301) 295-1933
| | - Patricia A. Sharpe
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208; Tel: (803) 777-4253, Fax: (803) 777-9007
| | - Dawnyéa Jackson
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 800 Sumter Street HESC, Columbia, SC 29208
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Prevalence and risk factors for oncogenic human papillomavirus infections in high-risk mid-adult women. Sex Transm Dis 2013; 39:848-56. [PMID: 23064533 DOI: 10.1097/olq.0b013e3182641f1c] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The epidemiology of high-risk (hr) human papillomavirus (HPV) infections in mid-adult women with new sex partners is undefined. METHODS We analyzed baseline data from 518 25- to 65-year-old women online daters. Women were mailed questionnaires and kits for self-collecting vaginal specimens for polymerase chain reaction-based hrHPV testing. Risk factors for infection were identified using Poisson regression models to obtain prevalence ratios (PRs). RESULTS The prevalence of hrHPV infection was 35.9%. In multivariate analysis restricted to sexually active women, the likelihood of hrHPV infection was associated with abnormal Papanicolaou test history (PR = 1.42, 95% confidence interval [CI]: 1.10-1.84), lifetime number of sex partners >14 (compared with 1-4; PR = 2.13, 95% CI: 1.13-4.02 for 15-24 partners; and PR = 1.91, 95% CI: 1.00-3.64 for ≥25 partners), male partners with ≥1 concurrent partnership (PR = 1.34, 95% CI: 1.05-1.71), and male partners whom the subject met online (PR = 1.39, 95% CI: 1.08-1.79). Age was inversely associated with infection only in women who were sexually inactive (PR = 0.67 per 5-year age difference, adjusted for Papanicolaou history and lifetime number of partners). Compared with sexually inactive women, the likelihood of infection increased with increasing risk level (from low-risk to hr partners; P < 0.0001 by trend test). In multivariate analysis, infection with multiple versus single hrHPV types was inversely associated with ever having been pregnant (PR = 0.64, 95% CI: 0.46-0.90) and recent consistent condom use (PR = 0.56, 95% CI: 0.32-0.97), and positively associated with genital wart history (PR = 1.43, 95% CI: 1.03-1.99). CONCLUSIONS Measures of both cumulative and recent sexual history were associated with prevalent hrHPV infection in this hr cohort of mid-adult women.
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Conway C, Chalkley R, High A, Maclennan K, Berri S, Chengot P, Alsop M, Egan P, Morgan J, Taylor GR, Chester J, Sen M, Rabbitts P, Wood HM. Next-generation sequencing for simultaneous determination of human papillomavirus load, subtype, and associated genomic copy number changes in tumors. J Mol Diagn 2012; 14:104-11. [PMID: 22240447 DOI: 10.1016/j.jmoldx.2011.10.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 10/17/2011] [Accepted: 10/26/2011] [Indexed: 12/01/2022] Open
Abstract
Human papillomavirus (HPV) infection in cases of squamous cell carcinoma of the oropharynx is a powerful predictive and prognostic biomarker. We describe how the use of next-generation sequencing can provide a novel method for the detection of HPV in DNA isolated from formalin-fixed paraffin-embedded tissues. Using this methodology in a cohort of 44 head and neck tumors, we identified the samples that contained HPV sequences, the viral subtype involved, and a direct readout of viral load. Specificity of HPV detection by sequencing compared to traditional detection methods using either PCR or p16 immunohistochemistry was 100%. Sensitivity was 50% when either compared to PCR [confidence interval (CI) = 29% to 71%] or 75% when compared to p16 (CI = 47% to 91%). In addition, we demonstrate the ability of next-generation sequencing to detect other HPV subtypes that would not have been detected by traditional methods, and we demonstrated the ability to apply this method to any tumor and any virus in a panel of eight human cancer cell lines. This methodology also provides a tumor genomic copy number karyogram, and in the samples analyzed here, a lower level of chromosome instability was detected in HPV-positive tumors compared to HPV-negative tumors, as observed in previous studies. Thus, the use of next-generation sequencing for the detection of HPV provides a multiplicity of data with clinical significance in a single test.
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Affiliation(s)
- Caroline Conway
- Section of Experimental Therapeutics, Leeds Institute of Molecular Medicine, St. James's University Hospital, Leeds, United Kingdom.
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Harawa NT, Leng M, Kim J, Cunningham WE. Racial/ethnic and gender differences among older adults in nonmonogamous partnerships, time spent single, and human immunodeficiency virus testing. Sex Transm Dis 2011; 38:1110-7. [PMID: 22082721 PMCID: PMC3226772 DOI: 10.1097/olq.0b013e31822e614b] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND A higher frequency of nonmonogamy, due in part to lower marriage prevalence, may contribute to elevated human immunodeficiency virus (HIV)/sexually transmitted disease rates among older blacks. METHODS To examine race and gender differences in nonmonogamy, time spent single (i.e., not married or cohabiting), and HIV testing in older adults, we analyzed US population-based data from the 2005-2006 National Social Life, Health, and Aging Project for 2825 heterosexual participants ages 57 to 85 years. RESULTS Blacks spent greater portions of their adult lives single than did Hispanics or whites and were far more likely to report recent nonmonogamous partnerships (23.4% vs. 10.0% and 8.2%). Among individuals reporting sex in the prior 5 years, nonmonogamous partnerships were strongly associated with time spent single during the period. Control for time spent single and other covariates reduced the association of black race with nonmonogamous partnerships for men, but increased it for women. Less than 20% reported ever testing for HIV; less than 6% had been recommended testing by a provider. Testing rates, highest in black men and white women, differed little by history of nonmonogamous partnerships within gender strata. CONCLUSIONS Singlehood helps to explain higher nonmonogamous partnership rates in older black men but not in older black women. Older adults rarely receive or are recommended HIV testing, a key strategy for reducing heterosexual HIV transmission.
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Affiliation(s)
- Nina T Harawa
- Charles R. Drew University of Medicine and Science, Department of Research, Los Angeles, CA 90059, USA.
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25
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Takehara K, Toda T, Nishimura T, Sakane J, Kawakami Y, Mizunoe T, Nishiwaki M, Taniyama K. Human papillomavirus types 52 and 58 are prevalent in uterine cervical squamous lesions from Japanese women. PATHOLOGY RESEARCH INTERNATIONAL 2011; 2011:246936. [PMID: 21660229 PMCID: PMC3109341 DOI: 10.4061/2011/246936] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 03/22/2011] [Indexed: 11/20/2022]
Abstract
Objective. To estimate the prevalence and genotypes of high-risk human papillomavirus (HPV) focusing HPV 16, 18, 52, and 58 in Japan. Methods. Liquid-base cytology specimens were collected from Japanese women (n = 11022), aged 14-98. After classifying cytodiagnosis, specimens were analyzed for HPV DNA by the multiplex polymerase chain reaction method, where 1195 specimens were positive for cervical smear, except adenomatous lesions. Result. HPV genotypes were detected in 9.5% of NILM and 72.2% of ASC-US or more cervical lesions. In positive cervical smears, HPV genotypes were HPV 52 at 26.6%, HPV 16 at 25.2%, HPV 58 at 21.8%, and HPV 18 at 7.1%. Most patients infected with HPV 16 were between 20-29 years old, decreasing with age thereafter. As for HPV 52 and 58, although the detection rate was high in 30- to 39-year-olds, it also was significant in the 50s and 60s age groups. Conclusion. In Japan, as a cause of abnormal cervical cytology, HPV52 and 58 are detected frequently in addition to HPV 16. In older age groups, HPV 52 and 58 detection rates were higher than that observed for HPV 16. After widespread current HPV vaccination, we still must be aware of HPV 52 and 58 infections.
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Affiliation(s)
- Kazuhiro Takehara
- Department of Obstetrics and Gynecology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
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26
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Abstract
As people age, many aspects of their lives tend to change, including the constellation of people with whom they are connected, their social context, their families, and their health--changes that are often interrelated. Wave I of the National Social Life, Health, and Aging Project (NSHAP) has yielded rich information on intimate ties, especially dyads and families, and on social connections generally. Combined with extensive biological and other health measures, NSHAP enables researchers to address key questions on health and aging. We begin with recent findings on intimate dyads, then move to social participation, and finally to elder mistreatment. Among dyads, we find that whereas sexual activity drops sharply with age for both women and men, gender differences in partner loss as well as psychosocial and normative pressures constrain women's sex more than men's. However, surviving partnerships tend to be emotionally and physically satisfying and are marked by relatively frequent sex. In contrast to sex, nonsexual intimacy is highly prevalent at older ages, especially among women. Older adults are also socially resilient--adapting to the loss of social ties by increasing involvement with community and kin networks. Despite these social assets, older adults remain vulnerable to mistreatment. Overall, these findings yield a mixed picture of gender-differentiated vulnerabilities balanced by proactive adaptation and maintenance of social and dyadic assets.
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Affiliation(s)
- Linda Waite
- Department of Sociology, University of Chicago, Chicago, IL 60637, USA.
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Tamalet C, Richet H, Carcopino X, Henry M, Leretraite L, Heid P, Leandri FX, Sancho-Garnier H, Piana L. Testing for human papillomavirus and measurement of viral load of HPV 16 and 18 in self-collected vaginal swabs of women who do not undergo cervical cytological screening in Southern France. J Med Virol 2010; 82:1431-7. [DOI: 10.1002/jmv.21835] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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28
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HPV infection among women in a representative rural and suburban population of the USA. Int J Gynaecol Obstet 2009; 105:210-4. [DOI: 10.1016/j.ijgo.2009.01.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Revised: 12/17/2008] [Accepted: 01/13/2009] [Indexed: 11/17/2022]
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