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Alshammari AH, Ishii H, Hirotsu T, Hatakeyama H, Morishita M, di Luccio E. Bridging the gap in cervical cancer screening for underserved communities: MCED and the promise of future technologies. Front Oncol 2024; 14:1407008. [PMID: 39135996 PMCID: PMC11317246 DOI: 10.3389/fonc.2024.1407008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/09/2024] [Indexed: 08/15/2024] Open
Abstract
Cervical cancer screening is a critical public health measure, especially vital for underserved communities where disparities in access and outcomes are pronounced. Despite the life-saving potential of regular screening, numerous barriers-including geographical isolation, cultural and linguistic challenges, and socioeconomic factors-severely hinder accessibility for these populations. Multicancer early detection (MCED) tests emerge as a potentially effective intervention, offering a less invasive, more accessible approach that could transform how screenings are conducted. This paper explores the existing challenges in traditional cervical cancer screening methods, the potential of MCED tests to address these barriers, and the implications of these technologies for global health equity. Through a comprehensive review, we highlight the need for culturally sensitive, tailored interventions and the importance of effectively overcoming logistical and financial difficulties to implement MCED tests. Despite the promise shown by MCED tests, the paper acknowledges significant implementation challenges, including cost, logistical obstacles, and the need for cultural acceptance and validation studies. This study emphasizes the necessity for equitable MCED test implementation strategies, highlighting the potential of these innovative technologies to advance global health equity in cervical cancer prevention.
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Affiliation(s)
| | - Hideshi Ishii
- Department of Medical Data Science, Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takaaki Hirotsu
- Shonan Research and Development Center, Hirotsu Bio Science Inc., Tokyo, Japan
| | - Hideyuki Hatakeyama
- Shonan Research and Development Center, Hirotsu Bio Science Inc., Tokyo, Japan
| | - Masayo Morishita
- Shonan Research and Development Center, Hirotsu Bio Science Inc., Tokyo, Japan
| | - Eric di Luccio
- Shonan Research and Development Center, Hirotsu Bio Science Inc., Tokyo, Japan
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Kulkarni SP, Paliwal S, Kosta S. Genotypic Diversity of Human Papillomavirus (HPV) Types and Its Prevalence With Cervical Cancer (CC) in Central India. Cureus 2023; 15:e35227. [PMID: 36968914 PMCID: PMC10032616 DOI: 10.7759/cureus.35227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 02/22/2023] Open
Abstract
Background The high-risk human papillomavirus (hr-HPV) is linked with cervical cancer (CC), and the distinct proportional impact of each genotype on the prevalence of the disease depends on the area. Therefore, to find out the prevalence of HPV types in women with cervical lesions from central India, the current study was performed. Methodology Age, prior history of cervical disease, changes in lifestyle characteristics, menopausal status, and HPV vaccination status were all carefully gathered at enrollment for the 736 women (aged 21 to 60) screened in this cross-sectional study who were referred for regular screening of cervical during the study period. Cervix was examined for lesions by visual inspection with acetic acid (VIA) screening and HPV genotypes were identified by real-time polymerase chain reaction (RT-PCR). Result Among 736 women 215 (29.2%) were in the 21-30 age group, 321 (43.6%) in the 31-40 age group, 132 (17.9%) in the 41-50 age group, and 68 (9.3%) cases in >50 age group. According to education, there were 398 (54.1 %) with primary and below education, 115 (15.6%) with secondary education, and 223 (30.3%) with college and above education. HPV-16, 18, 31, and 45 each had a prevalence of 29.6%, 11.1%, 12.9%, and 9.2%, respectively, while the overall prevalence of hr-HP) was present in populations at 7.3% in individuals and 37.0% in combinations. Hr-HPV infection and prevalence were provocatively more (79.6%) in the VIA-positivity rate with CC. Conclusion Individual hr-HPV genotype prevalence was shown to be lower than with combinations (HPV-16, 18, 31, and 45). The HPV-16 genotype was identified to have a higher prevalence than HPV-18, 31, and 45. However, more awareness programs are needed for a better understanding of CC and HPV testing in central India.
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Parra SG, López-Orellana LM, Molina Duque AR, Carns JL, Schwarz RA, Smith CA, Ortiz Silvestre M, Diaz Bazan S, Escobar PA, Felix JC, Ramalingam P, Castle PE, Cremer ML, Maza M, Schmeler KM, Richards-Kortum RR. Cervical cancer prevention in El Salvador: A prospective evaluation of screening and triage strategies incorporating high-resolution microendoscopy to detect cervical precancer. Int J Cancer 2021; 148:2571-2578. [PMID: 33368249 PMCID: PMC10568648 DOI: 10.1002/ijc.33454] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/16/2020] [Accepted: 11/27/2020] [Indexed: 01/28/2023]
Abstract
Cervical cancer remains a leading cause of cancer death for women in low- and middle-income countries. The goal of our study was to evaluate screening and triage strategies, including high-resolution microendoscopy (HRME), to detect cervical abnormalities concerning for precancer at the point of care. Women (n = 1824) were enrolled at the Instituto de Cáncer de El Salvador. All underwent screening by both human papillomavirus (HPV) testing using careHPV and visual inspection with acetic acid (VIA). Screen-positives, along with 10% of screen-negatives, were invited to return for a follow-up examination that included triage with VIA, colposcopy and HRME imaging. Biopsies were taken of any abnormalities identified. If no abnormalities were identified, then the worst scoring site by HRME was biopsied. The sensitivities of HPV testing and VIA to screen for cervical intraepithelial neoplasia Grade 2 or more severe diagnoses (CIN2+) were 82.1% and 75% (P = .77), while the specificities were 90.4% and 80.9% (P < .001), respectively. The sensitivities of VIA, colposcopy and HRME as triage tests for CIN2+ were 82.1%, 82.1% and 71.4%, respectively (P ≥ .38). HRME had a significantly higher specificity (66.7%) than VIA (51.9%) (P < .001) and colposcopy (53.3%) (P < .001). When evaluating different theoretical screening and triage strategies, screening with HPV testing followed by triage with HRME would result in more women receiving appropriate care (97%) compared to screening with VIA (75%) or HPV alone (90%). Our findings demonstrate that screening with HPV is superior to VIA, and that triage with HRME imaging increases the specificity of detecting CIN2+ at the point of care in a low-resource setting.
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Affiliation(s)
- Sonia G Parra
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | | | | | - Jennifer L Carns
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | | | - Chelsey A Smith
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | | | | | - Pablo A Escobar
- Liga Contra el Cáncer de El Salvador, San Salvador, El Salvador
| | - Juan C Felix
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Preetha Ramalingam
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Philip E Castle
- Divisions of Cancer Prevention and Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Miriam L Cremer
- Basic Health International, San Salvador, El Salvador
- Women's Health Institute, Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Mauricio Maza
- Basic Health International, San Salvador, El Salvador
| | - Kathleen M Schmeler
- Department of Gynecological Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Temesgen MM, Alemu T, Shiferaw B, Legesse S, Zeru T, Haile M, Gelanew T. Prevalence of oncogenic human papillomavirus (HPV 16/18) infection, cervical lesions and its associated factors among women aged 21-49 years in Amhara region, Northern Ethiopia. PLoS One 2021; 16:e0248949. [PMID: 33760866 PMCID: PMC7990306 DOI: 10.1371/journal.pone.0248949] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 03/08/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is considered as the major risk factor for the development of cervical cancer, second most frequent cancer in Ethiopia. However, the magnitude of the problem and the associated factors remain unrevealed in the Amhara region. This study aimed to determine the prevalence of HPV infection and factors contributing to the progression of HPV infection to cervical cancer. METHODS Facility-based cross-sectional study design was employed among women aged 21 to 49 years of age who came for routine cervical cancer screening to 4 randomly selected hospitals (2 general and 2 referral) of Amhara region from May to October, 2019. The sample size was calculated by using the single population proportion formula, proportionated to hospitals, and women were recruited consecutively. Socio demographic and clinical data were collected using a pretested questionnaire and detection of HPV infection was done using HPV test (OncoE6TM Cervical Test) specific to HPV16/18 in cervical swabs. Visual inspection with acetic acid (VIA) was used to determine cervical lesions (precancerous and cancerous). Descriptive statistics and bivariate and multivariate logistic regression were used to describe HR-HPV and cervical lesions burden and association between HR-HPV, and cervical lesions and potential risk factors. RESULTS Among 337 women 21 to 49 years (median age of 35 years ±SD = 7.1 years) of age enrolled in the study, The overall prevalence of oncogenic HPVs (HPV16/18) and the VIA-positivity rate, possible an indicative of cervical lesions, were 7.1% and 13.1%, respectively. Logistic regression analysis showed a significant association between early age of first sexual intercourse (COR = 2.26; 95% CI: 1.0-5.05) and level of education (COR = 0.31; 95% CI: 0.12-0.78) with cervical lesions. Higher odds of HPV positivity (COR = 1.56; 95% CI: 0.59-4.11, p = 0.36) and VIA positivity (COR = 1.39; 95% CI: 0.64-3.00, p = 0.39) were observed among participants who had a history of sexually transmitted illnesses (STIs). CONCLUSIONS There was a relatively low prevalence of oncogenic HPV 16/18 and VIA-positivity in women attending four hospitals in the Amhara Region. Early age sexual contact, high parity, and being uneducated/low level of education were independently associated factors with HR-HPV infection and development of cervical lesions, highlighting the importance of prioritizing the limited HPV testing to those risk groups.
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Affiliation(s)
| | - Tefera Alemu
- Amhara Public Health Institute Dessie Branch, Dessie, Ethiopia
| | | | - Seid Legesse
- Amhara Public Health Institute Dessie Branch, Dessie, Ethiopia
| | - Taye Zeru
- Amhara Public Health Institute, Bahir Dar, Ethiopia
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Derbie A, Mekonnen D, Misgan E, Alemu YM, Woldeamanuel Y, Abebe T. Low level of knowledge about cervical cancer among Ethiopian women: a systematic review and meta-analysis. Infect Agent Cancer 2021; 16:11. [PMID: 33568189 PMCID: PMC7876815 DOI: 10.1186/s13027-021-00350-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/28/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction Cervical cancer is one of the leading causes of malignancies among women in Ethiopia. Knowing the disease could empower women to make an informed decision regarding participation with cervical cancer prevention strategies. There is scarcity of compiled data in the field. Therefore, this systematic review aimed to provide an overview of knowledge about cervical cancer among Ethiopian women. Methods We conducted a systematic review of peer-reviewed articles on the knowledge of cervical cancer. Articles were systematically searched using comprehensive search strings from PubMed/Medline, SCOPUS, and grey literature from Google Scholar. Two reviewers assessed study eligibility, extracted data, and the risk of bias independently. Meta-analysis was performed using STATA v 14 to pool the overall knowledge of the women about cervical cancer. Results We included 26 articles published between 2013 and 2020 covering a total of 14,549 participants. All the included articles had good methodological quality. The proportion of participants who had heard of cervical cancer varied from 4.6 to 87.7% with the pooled estimate at 56% (95% CI: 47–66). Similarly, the proportion of participants who knew that HPV is the main cause of cervical cancer lied between 0 and 49.7% with the pooled result at 21% (95% CI: 13–30). Likewise, the pooled prevalence to identify at least one risk factor, one symptom of cervical cancer and ever heard of cervical cancer screening was gauged at 52% (95% CI: 39–64), 43% (95% CI: 26–60), and 39% (95% CI: 24–55), respectively. The overall pooled prevalence of good knowledge about cervical cancer was at 43% (95% CI: 33–53). On top of this, the prevalence of previous screening practice among the participants was at 14% (95% CI: 9–20). Conclusions Knowledge about cervical cancer among Ethiopian women is quite poor. Therefore, health education to provide sufficient and unbiased information about HPV and cervical cancer in general is required to the public.
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Affiliation(s)
- Awoke Derbie
- Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia. .,Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia. .,Department of Health Biotechnology, Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Daniel Mekonnen
- Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.,Department of Health Biotechnology, Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyaya Misgan
- Department of Gynecology and Obstetrics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yihun Mulugeta Alemu
- Departent of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yimtubezinash Woldeamanuel
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia.,Department of Medical Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tamrat Abebe
- Department of Medical Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Appidi T, Mudigunda SV, Kodandapani S, Rengan AK. Development of label-free gold nanoparticle based rapid colorimetric assay for clinical/point-of-care screening of cervical cancer. NANOSCALE ADVANCES 2020; 2:5737-5745. [PMID: 36133887 PMCID: PMC9419083 DOI: 10.1039/d0na00686f] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/05/2020] [Indexed: 05/28/2023]
Abstract
Cervical cancer is the fourth largest cancer, affecting women across the globe. Rapid screening is of vital importance for diagnosis and treatment of the disease, especially in developing countries with high risk populations. In this paper, we report a simple, novel and rapid approach for qualitative screening of cervical cancer. A label-free colorimetric technique ("C-ColAur") involving the in situ formation of gold nanoparticles (Au NPs) in the presence of clinical samples is demonstrated. The as-formed Au NPs, owing to the sample composition produced a characteristic color that can be used for the qualitative detection of malignancy. We demonstrated the proof of principle using clinical samples (cervical fluid) collected from both cancer affected and healthy individuals. The results of the detection technique, "C-ColAur" when compared with those of the existing conventional diagnostic procedures (i.e. Pap smear or biopsy), showed 96.42% sensitivity. With the detection time less than a minute and with no/minimal sample processing requirements, the proposed technique shows great potential for point-of-care as well as clinical screening of cervical cancer.
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Affiliation(s)
- Tejaswini Appidi
- Dept. of Biomedical Engineering, Indian Institute of Technology Hyderabad Sangareddy Kandi 502285 Telangana India
| | - Sushma V Mudigunda
- Dept. of Biomedical Engineering, Indian Institute of Technology Hyderabad Sangareddy Kandi 502285 Telangana India
| | - Suseela Kodandapani
- Dept. of Pathology, Basavatarakam Indo-American Cancer Hospital & Research Institute Hyderabad Telangana India
| | - Aravind Kumar Rengan
- Dept. of Biomedical Engineering, Indian Institute of Technology Hyderabad Sangareddy Kandi 502285 Telangana India
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Hull R, Mbele M, Makhafola T, Hicks C, Wang SM, Reis RM, Mehrotra R, Mkhize-Kwitshana Z, Kibiki G, Bates DO, Dlamini Z. Cervical cancer in low and middle-income countries. Oncol Lett 2020; 20:2058-2074. [PMID: 32782524 PMCID: PMC7400218 DOI: 10.3892/ol.2020.11754] [Citation(s) in RCA: 179] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 10/16/2019] [Indexed: 12/11/2022] Open
Abstract
Cervical cancer is a malignant tumour that occurs in the cervix and is classified into two histological types, adenocarcinoma and squamous cell carcinoma (SCC); SCC is more common and accounts for 70% of all cases. In 2018 there were ~569,000 new cases of cervical cancer diagnosed worldwide and ~311,000 deaths were attributed to cervical cancer. Of these, between 84 and 90% occurred in low- and middle-income countries (LMICs) such as South Africa, India, China and Brazil. The most common cause of cervical cancer is persistent infection caused by the sexually transmitted human papilloma virus. Other factors that contribute to the incidence of cervical cancer include geography, traditional practices and beliefs, the screening levels, socioeconomic status, healthcare access, public awareness, use of oral contraceptives, smoking and co-infection with HIV. An estimated 11 million women from LMICs will be diagnosed with cervical cancer in the next 10-20 years. The aim of this review was to explore various types of genetic and epigenetic factors that influence the development, progression or suppression of cervical cancer.
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Affiliation(s)
- Rodney Hull
- SA-MRC/UP Precision Prevention and Novel Drug Targets for HIV-Associated Cancers Extramural Unit, Pan African Cancer Research Institute, Faculty of Health Sciences, University of Pretoria, Hatfield 0028, South Africa
| | - Mzwandile Mbele
- SA-MRC/UP Precision Prevention and Novel Drug Targets for HIV-Associated Cancers Extramural Unit, Pan African Cancer Research Institute, Faculty of Health Sciences, University of Pretoria, Hatfield 0028, South Africa
| | - Tshepiso Makhafola
- SA-MRC/UP Precision Prevention and Novel Drug Targets for HIV-Associated Cancers Extramural Unit, Pan African Cancer Research Institute, Faculty of Health Sciences, University of Pretoria, Hatfield 0028, South Africa
| | - Chindo Hicks
- Bioinformatics and Genomics Centre, School of Medicine, Department of Genetics, Louisiana State University, New Orleans, LA 70112, USA
| | - Shao-Ming Wang
- National Cancer Centre, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Rui Manuel Reis
- Molecular Oncology Research Centre, Barretos Cancer Hospital, Sao Paulo 14784-400, Brazil
| | - Ravi Mehrotra
- Indian Council of Medical Research, New Delhi, Delhi 110029, India
| | | | - Gibson Kibiki
- East African Health Research Commission, East African Community, Bujumbura, Bujumbura Mairie 350, Burundi
| | - David O Bates
- Queen's Medical Centre, University of Nottingham, Nottingham, Nottinghamshire NG7 2UH, UK
| | - Zodwa Dlamini
- SA-MRC/UP Precision Prevention and Novel Drug Targets for HIV-Associated Cancers Extramural Unit, Pan African Cancer Research Institute, Faculty of Health Sciences, University of Pretoria, Hatfield 0028, South Africa
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Derbie A, Mekonnen D, Woldeamanuel Y, Van Ostade X, Abebe T. HPV E6/E7 mRNA test for the detection of high grade cervical intraepithelial neoplasia (CIN2+): a systematic review. Infect Agent Cancer 2020; 15:9. [PMID: 32047531 PMCID: PMC7006188 DOI: 10.1186/s13027-020-0278-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/03/2020] [Indexed: 01/31/2023] Open
Abstract
Background Genital infection with certain types of Human papillomavirus (HPV) is a major cause of cervical cancer globally. For early detection of premalignant dysplasia, evidences are coming out on the usefulness of HPV E6/E7 mRNA test as a potential tool compared with cytology and HPV DNA testing. Taking into account shortage of compiled data on this field, the aim of this systematic review was to describe the latest diagnostic performance of HPV E6/E7 mRNA testing to detect high grade cervical lesions (CIN2+) where by histology was taken as a gold standard. Methods Articles published in English were systematically searched using key words from PubMed/Medline and SCOPUS. In addition, Google Scholar and the Google database were searched manually for grey literature. Two reviewers independently assessed study eligibility, risk of bias and extracted the data. We performed a descriptive presentation of the performance of E6/E7 mRNA test (in terms of sensitivity, specificity, negative and positive predictive values) for the detection of CIN2 + . Results Out of 231 applicable citations, we have included 29 articles that included a total of 23,576 study participants (age range, 15–84 years) who had different cervical pathologies. Among the participants who had cervical histology, the proportion of CIN2+ was between 10.6 and 90.6%. Using histology as a gold standard, 11 studies evaluated the PreTect HPV Proofer, 7 studies evaluated the APTIMA HPV assay (Gen-Probe) and 6 studies evaluated the Quantivirus® HPV assay. The diagnostic performance of these three most common mRNA testing tools to detect CIN2+ was; 1) PreTect Proofer; median sensitivity 83%, specificity 73%, PPV 70 and NPV 88.9%. 2) APTIMA assay; median sensitivity 91.4%, specificity 46.2%, PPV 34.3% and NPV 96.3%. 3) Quantivirus®: median sensitivity 86.1%, specificity 54.6%, PPV 54.3% and NPV was at 89.3%. Further, the area under the receiver operating characteristics (AU-ROC) curve varied between 63.8 and 90.9%. Conclusions The reported diagnostic accuracy implies that HPV mRNA based tests possess diagnostic relevance to detect CIN2+ and could potentially be considered in areas where there is no histology facility. Further studies including its cost should be considered.
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Affiliation(s)
- Awoke Derbie
- 1Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.,2Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Daniel Mekonnen
- 1Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.,3Department of Health Biotechnology, Biotechnology Research Institute, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yimtubezinash Woldeamanuel
- 2Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia.,4Department of Medical Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Xaveer Van Ostade
- 5Laboratory of Protein Science, Proteomics and Epigenetic Signaling (PPES), Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Tamrat Abebe
- 4Department of Medical Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Cervical cancer treatment in Haiti: A vertically-integrated model for low-resource settings. Gynecol Oncol Rep 2019; 28:71-75. [PMID: 30963084 PMCID: PMC6434067 DOI: 10.1016/j.gore.2019.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/08/2019] [Accepted: 03/14/2019] [Indexed: 11/24/2022] Open
Abstract
Raising awareness is critical to any cancer program and through our outreach events we were able to educate 33,258 women. We have treated over 4500 women with VIA and cryotherapy or thermocoagulation. At least 30 of our patients are currently receiving individualized chemotherapy, whether neoadjuvant, adjuvant or palliative. We have brought 17 qualified patients to the operating room for radical hysterectomy. Our goal is to train and establish an independently functioning Haitian oncology program.
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Mohamad KAA, Saad AS, Murad AWA, Altraigy A. Visual inspection after acetic acid (VIA) as an alternative screening tool for cancer cervix. APOLLO MEDICINE 2016. [DOI: 10.1016/j.apme.2016.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Hasahya OT, Berggren V, Sematimba D, Nabirye RC, Kumakech E. Beliefs, perceptions and health-seeking behaviours in relation to cervical cancer: a qualitative study among women in Uganda following completion of an HPV vaccination campaign. Glob Health Action 2016; 9:29336. [PMID: 26895145 PMCID: PMC4759844 DOI: 10.3402/gha.v9.29336] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 12/08/2015] [Accepted: 12/21/2015] [Indexed: 01/12/2023] Open
Abstract
Background Cervical cancer remains a leading cause of morbidity and mortality in Uganda. Despite earlier information campaigns to introduce human papilloma virus (HPV) vaccination, which also targeted cervical cancer, misinterpretation and misunderstanding of the subject remain high. Women in Uganda present with cervical cancer at an advanced stage due to poor health-seeking behaviours, with an associated high mortality rate. This project explored beliefs, attitudes, perceptions, and health-seeking behaviours in relation to cervical cancer among women in Uganda after an HPV vaccination project had been rolled out. Design A qualitative study design was used, with six focus group discussions (FGDs) that included 36 women, aged 25–49 years, with no previous history of cervical cancer symptoms or diagnosis. The women were interviewed in February and March 2013. The transcribed data was analysed using content analysis. Results Three themes emerged: feeling unprotected and unsafe, misbelief and wondering about cervical cancer, and fear of the testing procedure. Participating women had heard of cervical cancer but preferred to wait to access cervical cancer screening until symptom debut. Conclusions There are still barriers to cervical cancer screening among women in Uganda, where there is a need for culture-specific, sensitive information and interventions to address the issues of improving the cervical cancer screening uptake among these women. Societal context needs to be taken into account when implementing community-based health education.
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Affiliation(s)
- Olivia Topister Hasahya
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.,Gynecological, Breast and Sarcoma Cancer, Department of Oncology, Karolinska University Hospital, Solna, Sweden;
| | - Vanja Berggren
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.,Faculty of Health Sciences, Lund University, Lund, Sweden
| | - Douglas Sematimba
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.,Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Edward Kumakech
- Makerere University College of Health Sciences, Kampala, Uganda
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Cervical Cancer Screening Program by Visual Inspection: Acceptability and Feasibility in Health Insurance Companies. Obstet Gynecol Int 2015; 2015:798453. [PMID: 26167178 PMCID: PMC4488550 DOI: 10.1155/2015/798453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/26/2015] [Indexed: 11/18/2022] Open
Abstract
Objective. To assess willingness to participate and diagnostic accuracy of visual inspection for early detection of cervical neoplasia among women in a health insurance company. Patients and Method. Cervical cancer screening was systematically proposed to 800 women after consecutive information and awareness sessions. The screening method was visual inspection with acetic acid (VIA) or Lugol's iodine (VILI). Results. Among the 800 identified women, 640 (82%) have accepted the screening, their mean age was 39 years, and 12.0% of them were involved in a polygamist couple. 28.2% of women had prior cervical screening. VIA has been detected positive in 5.9% of women versus 8.6% for VILI. The sensitivity was 72.9% and specificity was 95.2% for VIA versus 71.2% and 97.3% for VILI respectively. The histological examination highlighted a nonspecific chronic cervicitis in 4.6%, CIN1 lesions in 5.91%, and CIN2/3 in 1.2% of the cases. Conclusion. Cervical cancer screening by visual inspection showed appropriate diagnostic accuracy when used to detect early cervical lesions. It is a simple and easy to perform method that could be introduced progressively in the health insurance policy while waiting for a national screening program.
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Yildirim JG, Arabaci Z. Innovations in HPV vaccination and roles of nurses in cervical cancer prevention. Asian Pac J Cancer Prev 2015; 15:10053-6. [PMID: 25556424 DOI: 10.7314/apjcp.2014.15.23.10053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The human papilloma virus (HPV) is the main aetiological agent for cervical cancer, one of the most frequent cancers observed in women throughout the world. There are effective programs for reducing the incidence of cervical cancer with HPV vaccination. The objective of this study was to discuss the applicability of the HPV vaccination and the role of nurses in prevention of cervical cancer. Use of bivalent and quadrivalent vaccines has been initiated against the types of HPV which are the primary cause of cancer. The quadrivalent HPV vaccination has entered into the routine vaccination schedule in many European countries for use in children and adolescents between 9-15 years of age and for women between 16-26 years of age, whereas it has been proposed that the bivalent vaccination should be given to girls between 9-18 years of age. While cervical cancer is among the cancers that can be prevented, it is essential to continue screening tests while introducing vaccination in a systematic manner for protection. On this subject, among the most important roles of nurses is to implement the screening programs by fulfilling the caregiving, training and consultancy roles for the society and especially, for high risk groups and to increase the awareness of the people.
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Affiliation(s)
- Julide Gulizar Yildirim
- Department of Community Health Nursing, Faculty of Nursing, Ege University, Izmir, Turkey E-mail :
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Abstract
Cancer is a leading cause of global mortality, and women in low- and middle- income countries are disproportionately affected due to vulnerabilities related to gender inequality, poverty and environmental factors. Cancers affecting women are given low priority in the developing world and resources for screening, diagnosing and treating cancer are limited. The Millennium Development Goals may serve as a guide to design programs that address the allocation of cancer services, equipment, medications and trained health care providers. This article aims to provide readers with strategies to advocate for gender parity in worldwide cancer control policies.
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Martin-Moreno JM, Anttila A, von Karsa L, Alfonso-Sanchez JL, Gorgojo L. Cancer screening and health system resilience: keys to protecting and bolstering preventive services during a financial crisis. Eur J Cancer 2012; 48:2212-8. [PMID: 22424881 DOI: 10.1016/j.ejca.2012.02.060] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 02/20/2012] [Indexed: 01/20/2023]
Abstract
The aim of this paper is to elucidate the rationale for sustaining and expanding cost-effective, population-based screening services for breast, cervical and colorectal cancers in the context of the current financial crisis. Our objective is not only to promote optimal delivery of high-quality secondary cancer prevention services, but also to underline the importance of strengthening comprehensive cancer control, and with it, health system response to the complex care challenges posed by all chronic diseases. We focus primarily on issues surrounding planning, organisation, implementation and resources, arguing that given the growing cancer burden, policymakers have ample justification for establishing and expanding population-based programmes that are well-organised, well-resourced and well-executed. In a broader economic context of rescue packages, deficits and cutbacks to government entitlements, health professionals must intensify their advocacy for the protection of vital preventive health services by fighting for quality services with clear benefits for population health outcomes.
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Affiliation(s)
- Jose M Martin-Moreno
- University of Valencia, Department of Preventive Medicine and Public Health, Av. Blasco Ibañez 15, 46010 Valencia, Spain.
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Yusuf N, Ali MA, Islam MF, Khanam JA. Screening of cervical cancer by VIA among women in Rajshahi Medical College Hospital. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2012. [DOI: 10.1016/s2222-1808(12)60017-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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