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Trott S, Lei F, Jay Christian W, Mao X, Lehmkuhl B, Kejner A. Geographic variation of HPV-associated cancer incidence in Kentucky using spatial scan statistics. Cancer Causes Control 2024; 35:817-824. [PMID: 38212533 DOI: 10.1007/s10552-023-01835-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 11/22/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE Populations with high cancer risk that are targeted for screening, education, and vaccination have been shown to increase rates of screening, which ultimately may improve timing of diagnosis and overall outcome for certain cancers. Spatial scan analysis provides a visual representation of areas with higher rates of disease. Limited research has used this methodology to assess HPV-associated cancers. Using, spatial scan statistics, our goal was to identify regions within Kentucky having significantly higher rates of HPV-associated tumors. These regions can be targeted for public health efforts in the form of education, vaccination, screening, and physician recruitment. METHODS The Kentucky Cancer Registry data from 1995 to 2016 and spatial scan statistics were used to identify county-level clusters with high-incidence of HPV-associated cancers after adjustment for age and sex. Anatomic sites included in this analysis were oropharynx, cervix, anus, penis, and vulva. RESULTS There was one high-rate cluster of oropharyngeal cancer, which was observed in the Louisville metropolitan region (Relative Risk [RR] = 1.24, p < 0.001). One high-rate cluster of anal and penile cancer incidence in men was identified that partially overlapped with the oropharyngeal cluster. There were five clusters of higher cervical, vulvar, and anal cancer incidence in females, one of which overlapped with the oropharyngeal cluster. CONCLUSION Overlapping clusters of HPV-associated cancers were identified at the county-level and included both urban and rural counties of Kentucky. Findings can assist in the design of public health interventions to increase screenings, promote vaccination, and recruit physicians in these regions to improve prevention, diagnosis, and early treatment of HPV-associated cancers.
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Affiliation(s)
- Skylar Trott
- Department of Otolaryngology, University of Kentucky, Lexington, KY, USA
| | - Feitong Lei
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - W Jay Christian
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA
| | - Xihua Mao
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA
| | - Ben Lehmkuhl
- Department of Otolaryngology, University of Kentucky, Lexington, KY, USA
| | - Alexandra Kejner
- Department of Otolaryngology, Medical University of South Carolina, Charleston, SC, USA.
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Choi CI, Lee SJ, Choi JB, Kim TH, Lee JW, Kim JM, Bae S. 2023 Korean sexually transmitted infections guidelines by the Korean Association of Urogenital Tract Infection and Inflammation: Human papillomavirus vaccination. Investig Clin Urol 2024; 65:108-114. [PMID: 38454819 PMCID: PMC10925737 DOI: 10.4111/icu.20230385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/22/2024] [Indexed: 03/09/2024] Open
Abstract
The Korean Association of Urogenital Tract Infection and Inflammation (KAUTII) and the Korea Disease Control and Prevention Agency updated the guidelines for human papillomavirus (HPV) vaccine against sexually transmitted HPV infections in Korea to respond to changing epidemiologic trends, evolving scientific evidence, and advances in laboratory diagnostics and research. Main purpose and recommendation of vaccination against HPV are as follows: (1) the purpose of HPV vaccine is to reduce the risk of genital warts and HPV-related cancers including cervical and vulvar cancer, head and neck cancer, anal cancer, and penile cancer; (2) in Korea, bivalent (16, 18) vaccines, quadrivalent vaccines (6, 11, 16, 18), and 9-valent vaccines (6, 11, 16, 18, 31, 33, 45, 52, 58) are used depending on the type of HPV; (3) bivalent and quadrivalent vaccines are national immunizations targeting girls aged 11-12 years and low-income young females aged 18-26 years (age and range of inoculation: routinely administered at 11 or 12 years of age, 2 doses at 0 and 6 months for 12-14 years of age; for females aged 15-26 years, 3 doses depending on the type of vaccine; vaccination can be given to those aged up to 45 years through consultation with a clinician); (4) in the case of administering 2 doses, at least 5 months apart; in the case of administering 3 doses, it is recommended to keep 4 weeks between the 1st and 2nd doses, 12 weeks between the 2nd and 3rd doses, and 5 months between the 1st and 3rd doses; (5) immunocompromised patients such as those with HIV, malignant neoplasms, and autoimmune diseases, and those undergoing transplantation or immunosuppressive therapy should receive 3 doses. HPV vaccine is not recommended during pregnancy.
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Affiliation(s)
- Chang Il Choi
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong, Korea
| | - Seung-Ju Lee
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Bong Choi
- Department of Urology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tae-Hyoung Kim
- Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jeong Woo Lee
- Department of Urology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jun Mo Kim
- Department of Urology, Soonchunhyang University Buchoen Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sangrak Bae
- Department of Urology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Khoo A, Boyer M, Jafri Z, Makeham T, Pham T, Khachigian LM, Floros P, Dowling E, Fedder K, Shonka D, Garneau J, O'Meara CH. Human Papilloma Virus Positive Oropharyngeal Squamous Cell Carcinoma and the Immune System: Pathogenesis, Immunotherapy and Future Perspectives. Int J Mol Sci 2024; 25:2798. [PMID: 38474047 DOI: 10.3390/ijms25052798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Oropharyngeal squamous cell carcinoma (OPSCC), a subset of head and neck squamous cell carcinoma (HNSCC), involves the palatine tonsils, soft palate, base of tongue, and uvula, with the ability to spread to adjacent subsites. Personalized treatment strategies for Human Papillomavirus-associated squamous cell carcinoma of the oropharynx (HPV+OPSCC) are yet to be established. In this article, we summarise our current understanding of the pathogenesis of HPV+OPSCC, the intrinsic role of the immune system, current ICI clinical trials, and the potential role of small molecule immunotherapy in HPV+OPSCC.
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Affiliation(s)
- A Khoo
- Department of Otolaryngology, Head & Neck Surgery, Canberra Health Services, Canberra, ACT 2601, Australia
| | - M Boyer
- Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Z Jafri
- Vascular Biology and Translational Research, Department of Pathology, School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - T Makeham
- Department of Otolaryngology, Head & Neck Surgery, Canberra Health Services, Canberra, ACT 2601, Australia
- ANU School of Medicine & Psychology, Australian National University, Canberra, ACT 0200, Australia
| | - T Pham
- Department of Otolaryngology, Head & Neck Surgery, Canberra Health Services, Canberra, ACT 2601, Australia
- ANU School of Medicine & Psychology, Australian National University, Canberra, ACT 0200, Australia
| | - L M Khachigian
- Vascular Biology and Translational Research, Department of Pathology, School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - P Floros
- St Vincent's Hospital, 390 Victoria Street, Sydney, NSW 2010, Australia
| | - E Dowling
- Department of Otolaryngology, Head & Neck Surgery, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - K Fedder
- Department of Otolaryngology, Head & Neck Surgery, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - D Shonka
- Department of Otolaryngology, Head & Neck Surgery, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - J Garneau
- Department of Otolaryngology, Head & Neck Surgery, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - C H O'Meara
- Department of Otolaryngology, Head & Neck Surgery, Canberra Health Services, Canberra, ACT 2601, Australia
- ANU School of Medicine & Psychology, Australian National University, Canberra, ACT 0200, Australia
- Department of Otolaryngology, Head & Neck Surgery, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
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Napolitano F, Angelillo S, Bianco A, Di Giuseppe G, Di Onofrio V, Licata F, Liguori G, Nobile CGA, Pavia M, Pelullo CP, Zito Marino F, Angelillo IF. Genital and Oral HPV Geno-Prevalence Measured through Urine and Saliva Samples in Young Adults in Italy. Vaccines (Basel) 2024; 12:205. [PMID: 38400188 PMCID: PMC10892725 DOI: 10.3390/vaccines12020205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The aims of the study were to determine, in the urine and oral samples of young adults, the genotype-specific prevalence of Human Papilloma Virus (HPV) infection, the HPV DNA type-specific prevalence in unvaccinated and vaccinated individuals, and the determinants of HPV infection. METHODS Selected participants were asked to fill in a self-administered questionnaire and to self-collect urine and saliva samples. RESULTS Among the 1002 participants, 81 (8.1%) resulted positive for HPV DNA. The most common low-risk genotype was HPV 42 (2.2%), followed by HPV 43 (0.8%), and 40 (0.5%). The HPV 51 was the most common high-risk genotype (1.5%) followed by HPV 66 (1%) and HPV 68 (1%), and no participants were infected with HPV genotypes 18, 33, 45. Females, those who have had one or more occasional sexual partner, those who never/rarely/sometimes used condoms during their sexual activity, those with a previous diagnosis of sexually transmitted infection, and those who were not vaccinated were more likely to be tested positive for HPV infection. CONCLUSIONS The low prevalence of genital HPV infections has provided evidence of the effectiveness of HPV vaccination both in vaccinated and not yet vaccinated subjects through herd immunity and indicated its decisive role in the changing epidemiology of circulating HPV genotypes in the population.
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Affiliation(s)
- Francesco Napolitano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Silvia Angelillo
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
| | - Aida Bianco
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Valeria Di Onofrio
- Department of Sciences and Technologies, University of Naples “Parthenope”, 80143 Naples, Italy
| | - Francesca Licata
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
| | - Giorgio Liguori
- Department of Medical, Movement and Wellbeing Sciences, University of Naples “Parthenope”, 80133 Naples, Italy
| | | | - Maria Pavia
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Concetta Paola Pelullo
- Department of Medical, Movement and Wellbeing Sciences, University of Naples “Parthenope”, 80133 Naples, Italy
| | - Federica Zito Marino
- Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Sharma R, Abbastabar H, Abdulah DM, Abidi H, Abolhassani H, Abrehdari-Tafreshi Z, Absalan A, Ali HA, Abu-Gharbieh E, Acuna JM, Adib N, Sakilah Adnani QE, Aghaei A, Ahmad A, Ahmad S, Ahmadi A, Ahmadi S, Ahmed LA, Ajami M, Al Hamad H, Al Hasan SM, Alanezi FM, Saeed Al-Gheethi AA, Al-Hanawi MK, Ali A, Ali BA, Alimohamadi Y, Aljunid SM, Ali Al-Maweri SA, Alqahatni SA, AlQudah M, Al-Raddadi RM, Al-Tammemi AB, Ansari-Moghaddam A, Anwar SL, Anwer R, Aqeel M, Arabloo J, Arab-Zozani M, Ariffin H, Artaman A, Arulappan J, Ashraf T, Askari E, Athar M, Wahbi Atout MM, Azadnajafabad S, Badar M, Badiye AD, Baghcheghi N, Bagherieh S, Bai R, Bajbouj K, Baliga S, Bardhan M, Bashiri A, Baskaran P, Basu S, Belgaumi UI, Nazer C Bermudez A, Bhandari B, Bhardwaj N, Bhat AN, Bitaraf S, Boloor A, Hashemi MB, Butt ZA, Chadwick J, Kai Chan JS, Chattu VK, Chaturvedi P, Cho WC, Darwesh AM, Dash NR, Dehghan A, Dhali A, Dianatinasab M, Dibas M, Dixit A, Dixit SG, Dorostkar F, Dsouza HL, Elbarazi I, Elemam NM, El-Huneidi W, Elkord E, Abdou Elmeligy OA, Emamian MH, Erkhembayar R, Ezzeddini R, Fadoo Z, Faiz R, Fakhradiyev IR, Fallahzadeh A, Faris MEM, Farrokhpour H, Fatehizadeh A, Fattahi H, Fekadu G, Fukumoto T, Gaidhane AM, Galehdar N, Garg P, Ghadirian F, Ghafourifard M, Ghasemi M, Nour MG, Ghassemi F, Gholamalizadeh M, Gholamian A, Ghotbi E, Golechha M, Goleij P, Goyal S, Mohialdeen Gubari MI, Gunasekera DS, Gunawardane DA, Gupta S, Habibzadeh P, Haeri Boroojeni HS, Halboub ES, Hamadeh RR, Hamoudi R, Harorani M, Hasanian M, Hassan TS, Hay SI, Heidari M, Heidari-Foroozan M, Hessami K, Hezam K, Hiraike Y, Holla R, Hoseini M, Hossain MM, Hossain S, Hsieh VCR, Huang J, Hussein NR, Hwang BF, Iravanpour F, Ismail NE, Iwagami M, Merin J L, Jadidi-Niaragh F, Jafarinia M, Jahani MA, Jahrami H, Jaiswal A, Jakovljevic M, Jalili M, Jamshidi E, Jayarajah U, Jayaram S, Jha SS, Jokar M, Joseph N, Kabir A, Kabir MA, Kadir DH, Kakodkar PV, Kalankesh LR, Kalankesh LR, Kalhor R, Kaliyadan F, Kamal VK, Kamal Z, Kamath A, Kar SS, Karimi H, Kaur N, Keikavoosi-Arani L, Keykhaei M, Khader YS, Khajuria H, Khan EA, Khan MN, Khan M, Khan MA, Khan YH, Khanmohammadi S, Khatatbeh MM, Khateri S, Khayamzadeh M, Khayat Kashani HR, Kim MS, Kompani F, Koohestani HR, Koulmane Laxminarayana SL, Krishan K, Kumar N, Kumar N, Kutluk T, Kuttikkattu A, Ching Lai DT, Lal DK, Lami FH, Lasrado S, Lee SW, Lee SW, Lee YY, Lee YH, Leong E, Li MC, Liu J, Madadizadeh F, Mafi AR, Mahjoub S, Malekzadeh R, Malik AA, Malik I, Mallhi TH, Mansournia MA, Martini S, Mathews E, Mathur MR, Meena JK, Menezes RG, Mirfakhraie R, Mirinezhad SK, Mirza-Aghazadeh-Attari M, Mithra P, Mohamadkhani A, Mohammadi S, Mohammadzadeh M, Mohan S, Mokdad AH, Al Montasir A, Montazeri F, Moradi M, Sarabi MM, Moradpour F, Moradzadeh M, Moraga P, Mosapour A, Motaghinejad M, Mubarik S, Muhammad JS, Murray CJ, Nagarajan AJ, Naghavi M, Nargus S, Natto ZS, Nayak BP, Nejadghaderi SA, Nguyen PT, Niazi RK, Noroozi N, Okati-Aliabad H, Okekunle AP, Ong S, Oommen AM, Padubidri JR, Pandey A, Park EK, Park S, Pati S, Patil S, Paudel R, Paudel U, Pirestani M, Podder I, Pourali G, Pourjafar M, Pourshams A, Syed ZQ, Radhakrishnan RA, Radhakrishnan V, Rahman M, Rahmani S, Rahmanian V, Ramesh PS, Rana J, Rao IR, Rao SJ, Rashedi S, Rashidi MM, Rezaei N, Rezaei N, Rezaei N, Rezaei S, Rezaeian M, Roshandel G, Chandan S, Saber-Ayad MM, Sabour S, Sabzmakan L, Saddik B, Saeed U, Safi SZ, Sharif-Askari FS, Sahebkar A, Sahoo H, Sajedi SA, Sajid MR, Salehi MA, Farrokhi AS, Sarasmita MA, Sargazi S, Sarode GS, Sarode SC, Sathian B, Satpathy M, Semwal P, Senthilkumaran S, Sepanlou SG, Shafeghat M, Shahabi S, Shahbandi A, Shahraki-Sanavi F, Shaikh MA, Shannawaz M, Sheikhi RA, Shobeiri P, Shorofi SA, Shrestha S, Siabani S, Singh G, Singh P, Singh S, Sinha DN, Siwal SS, Sreeram S, Suleman M, Abdulkader RS, Sultan I, Sultana A, Tabish M, Tabuchi T, Taheri M, Talaat IM, Tehrani-Banihashemi A, Temsah MH, Thangaraju P, Thomas N, Thomas NK, Tiyuri A, Tobe-Gai R, Toghroli R, Tovani-Palone MR, Ullah S, Unnikrishnan B, Upadhyay E, Tahbaz SV, Valizadeh R, Varthya SB, Waheed Y, Wang S, Wickramasinghe DP, Wickramasinghe ND, Xiao H, Yonemoto N, Younis MZ, Yu C, Zahir M, Zaki N, Zamanian M, Zhang ZJ, Zhao H, Zitoun OA, Zoladl M. Temporal patterns of cancer burden in Asia, 1990-2019: a systematic examination for the Global Burden of Disease 2019 study. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 21:100333. [PMID: 38361599 PMCID: PMC10866992 DOI: 10.1016/j.lansea.2023.100333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 02/17/2024]
Abstract
Background Cancers represent a challenging public health threat in Asia. This study examines the temporal patterns of incidence, mortality, disability and risk factors of 29 cancers in Asia in the last three decades. Methods The age, sex and year-wise estimates of incidence, mortality, and disability-adjusted life years (DALYs) of 29 cancers for 49 Asian countries from 1990 through 2019 were generated as a part of the Global Burden of Disease, Injuries and Risk Factors 2019 study. Besides incidence, mortality and DALYs, we also examined the cancer burden measured in terms of DALYs and deaths attributable to risk factors, which had evidence of causation with different cancers. The development status of countries was measured using the socio-demographic index. Decomposition analysis was performed to gauge the change in cancer incidence between 1990 and 2019 due to population growth, aging and age-specific incidence rates. Findings All cancers combined claimed an estimated 5.6 million [95% uncertainty interval, 5.1-6.0 million] lives in Asia with 9.4 million [8.6-10.2 million] incident cases and 144.7 million [132.7-156.5 million] DALYs in 2019. The age-standardized incidence rate (ASIR) of all cancers combined in Asia was 197.6/100,000 [181.0-214.4] in 2019, varying from 99.2/100,000 [76.1-126.0] in Bangladesh to 330.5/100,000 [298.5-365.8] in Cyprus. The age-standardized mortality rate (ASMR) was 120.6/100,000 [110.1-130.7] in 2019, varying 4-folds across countries from 71.0/100,000 [59.9-83.5] in Kuwait to 284.2/100,000 [229.2-352.3] in Mongolia. The age-standardized DALYs rate was 2970.5/100,000 [2722.6-3206.5] in 2019, varying from 1578.0/100,000 [1341.2-1847.0] in Kuwait to 6574.4/100,000 [5141.7-8333.0] in Mongolia. Between 1990 and 2019, deaths due to 17 of the 29 cancers either doubled or more, and 20 of the 29 cancers underwent an increase of 150% or more in terms of new cases. Tracheal, bronchus, and lung cancer (both sexes), breast cancer (among females), colon and rectum cancer (both sexes), stomach cancer (both sexes) and prostate cancer (among males) were among top-5 cancers in most Asian countries in terms of ASIR and ASMR in 2019 and cancers of liver, stomach, hodgkin lymphoma and esophageal cancer posted the most significant decreases in age-standardized rates between 1990 and 2019. Among the modifiable risk factors, smoking, alcohol use, ambient particulate matter (PM) pollution and unsafe sex remained the dominant risk factors between 1990 and 2019. Cancer DALYs due to ambient PM pollution, high body mass index and fasting plasma glucose has increased most notably between 1990 and 2019. Interpretation With growing incidence, cancer has become more significant public health threat in Asia, demanding urgent policy attention and guidance. Its heightened risk calls for increased cancer awareness, preventive measures, affordable early-stage detection, and cost-effective therapeutics in Asia. The current study can serve as a useful resource for policymakers and researchers in Asia for devising interventions for cancer management and control. Funding The GBD study is funded by the Bill and Melinda Gates Foundation.
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Giuliano AR, Felsher M, Waterboer T, Mirghani H, Mehanna H, Roberts C, Chen YT, Lynam M, Pedrós M, Sanchez E, Sirak B, Surati S, Alemany L, Morais E, Pavón MA. Oral Human Papillomavirus Prevalence and Genotyping Among a Healthy Adult Population in the US. JAMA Otolaryngol Head Neck Surg 2023; 149:783-795. [PMID: 37535349 PMCID: PMC10401396 DOI: 10.1001/jamaoto.2023.1573] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/07/2023] [Indexed: 08/04/2023]
Abstract
Importance In the US, oropharyngeal cancer, predominantly caused by high-risk (HR) human papillomavirus (HPV) infection, is the most frequent HPV-associated cancer, surpassing cervical cancer. However, little is known about oral HPV prevalence and genotype distribution in the general population. Objective To assess oral HPV prevalence and factors associated with HR and low-risk infection in a general US population. Design, Setting, and Participants PROGRESS (Prevalence of Oral HPV Infection, a Global Assessment) was a cross-sectional observational study conducted between November 2021 and March 2022 in 43 dental offices in the US (24 urban, 13 urban cluster, and 6 rural sites), spanning 21 states. Eligible participants were aged 18 to 60 years, visiting dental clinics for routine dental examination. Dental clinics used targeted sampling to recruit equal distributions of men and women and across age groups. Exposure Participants provided an oral gargle specimen for HPV DNA and genotyping and completed behavioral questionnaires, and dentists reported oral health status. Detection of HPV DNA and genotyping was performed using the SPF10/DEIA/LiPA25 system at a central laboratory. Main Outcome Oral HPV prevalence. Results Of the 3196 participants enrolled, mean (SD) age was 39.6 (12.1) years, and 55.5% were women. Oral HPV prevalence was 6.6% (95% CI, 5.7%-7.4%) for any HPV genotype, and 2.0% (95% CI, 1.5%-2.5%), 0.7% (95% CI, 0.4%-1.0%), and 1.5% (95% CI, 1.1%-1.9%) for HR, HPV-16, and 9-valent-HPV vaccine types, respectively. Among HPV-positive participants, HPV-16 was the most prevalent genotype (12.4% among men and 8.6% among women). Prevalence of HPV was higher in men than women and highest among men aged 51 to 60 years (16.8%, 6.8%, and 2.1% for any HPV, HR HPV, and HPV-16, respectively). Factors associated with HR oral infection included being male (adjusted odds ratio [AOR], 3.1; 95% CI, 1.2-8.5), being aged 51 to 60 years (AOR, 3.3; 95% CI, 1.5-7.3), having 26 or more lifetime male sex partners (AOR, 6.5; 95% CI, 2.3-18.7), and having 6 to 25 lifetime female oral sex partners (AOR, 3.4; 95% CI, 1.3-8.7). Conclusions and Relevance In this cross-sectional study, oral HPV burden was highest among older men who may be at higher risk of developing oropharyngeal cancer. In addition to male sex and older age, HR oral HPV infection was also associated with sexual behaviors, including increasing number of male sex partners and female oral sex partners.
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Affiliation(s)
- Anna R. Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Marisa Felsher
- Center for Observational and Real-World Evidence (CORE), Merck & Co, Inc, Rahway, New Jersey
| | - Tim Waterboer
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Haïtham Mirghani
- Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Hisham Mehanna
- Institute of Head & Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, England
| | - Craig Roberts
- Center for Observational and Real-World Evidence (CORE), Merck & Co, Inc, Rahway, New Jersey
| | - Ya-Ting Chen
- Center for Observational and Real-World Evidence (CORE), Merck & Co, Inc, Rahway, New Jersey
| | | | | | | | - Bradley Sirak
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Shikha Surati
- Center for Observational and Real-World Evidence (CORE), Merck & Co, Inc, Rahway, New Jersey
| | - Laia Alemany
- Unit of Molecular Epidemiology and Genetics (UNIC EMG), Cancer Epidemiology Research Program, Catalan Institute of Oncology, ICO, L’Hospitalet, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Miquel Angel Pavón
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Laboratory Infections and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, ICO, L’Hospitalet, Barcelona, Spain
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Paduano G, Vaienna S, Maisto G, Di Giuseppe G, Pavia M. Investigating women's awareness and perceptions on human papillomavirus infection and oropharyngeal cancer in Italy. Front Public Health 2023; 11:1195588. [PMID: 37701909 PMCID: PMC10493318 DOI: 10.3389/fpubh.2023.1195588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/11/2023] [Indexed: 09/14/2023] Open
Abstract
Introduction This study explored knowledge, attitudes and behaviors toward human papillomavirus (HPV) infection and oropharyngeal cancer (OPC) among women attending primary care services. Methods The cross-sectional study was conducted from September to December 2022 in adult women attending three primary care services in Italy, who were invited to complete a self-administered questionnaire. Results Overall, 34.7% of participants know that OPC is HPV-associated; knowledge was higher among women who had personal, familiar or friends' experience of cancer, and who reported to often seek dental care, whereas it was lower in older women. The perception of risk of developing OPC was high for 26.4% of women and was higher in those who had experienced STD, who knew that early sexual debut is a risk factor for OPC, and who considered useful the role of dentists on the provision of information about OPC. Only 22.5% had received HPV vaccination, but 62% intended to receive it in the future. Moreover, 63.2% believe that HPV vaccination is very useful to prevent OPC and only 27% are concerned about health consequences of HPV vaccination. Conclusion These findings indicate that women's awareness of the role of HPV infection in the development of OPC is not satisfactory and underline the role that dentists might have in improving their patients' awareness on HPV related OPC.
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Affiliation(s)
| | | | | | | | - Maria Pavia
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Brzeziński M, Stukan M. Anal Cancer and Anal Intraepithelial Neoplasia Risk among Patients Treated for HPV-Related Gynecological Diseases-A Systematic Review. J Clin Med 2023; 12:4216. [PMID: 37445251 DOI: 10.3390/jcm12134216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/15/2023] [Accepted: 06/17/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The most important causative agent of neoplasms in the anogenital area is the human papillomavirus (HPV). Due to the anatomical proximity of the genital and anus area and the ease with which HPV infection is transmitted, it seems that patients after the treatment of HPV-related gynecological diseases may have an increased risk of developing a second HPV-related neoplasm anal cancer. The aim of this study was to determine the risk of anal intraepithelial neoplasia (AIN) and anal cancer (AC) among patients after the treatment of HPV-related gynecological diseases. METHODS We conducted a comprehensive review of the available literature from multiple databases. The study was performed following Cochrane Reviewers' Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines. Moreover, we assessed the quality of each study using QUADAS-2. RESULTS Twenty-five studies were included in the final analysis. Patients after the treatment of HPV-related gynecological diseases have a significantly higher risk of AC (mean standardized incidence ratio (SIR) = 5.387, mean incidence risk (IR) = 0.096%, mean IR per 100,000 person-years = 10.37) and AIN (mean IR = 23.683%) compared to the population risk. CONCLUSIONS patients with HPV-related gynecological diseases should constitute a group for which an appropriate primary and secondary screening for AC should be introduced.
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Affiliation(s)
- Michał Brzeziński
- Department of Gynecological Oncology, Pomeranian Hospitals, 81-519 Gdynia, Poland
- Division of Oncological Propedeutics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Maciej Stukan
- Department of Gynecological Oncology, Pomeranian Hospitals, 81-519 Gdynia, Poland
- Division of Oncological Propedeutics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
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Raslan S, Anis MM. HPV+ Oropharyngeal Cancer in Waldenström Macroglobulinemia. Cureus 2023; 15:e38965. [PMID: 37313073 PMCID: PMC10259752 DOI: 10.7759/cureus.38965] [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: 10/16/2022] [Accepted: 05/13/2023] [Indexed: 06/15/2023] Open
Abstract
We present a case of squamous cell carcinoma (SCC) in the setting of Waldenström macroglobulinemia (WM). A 68-year-old male and daily marijuana smoker with recently diagnosed WM presented via telemedicine in 2020 for a progressively worsening sore throat and unintentional weight loss. Immunotherapy for WM was delayed due to the COVID-19 pandemic. In the clinic, examination revealed an indurated, tender midline mass at the base of the tongue, not limiting tongue mobility. The left level-II and right level-III lymph nodes were enlarged. The oropharyngeal lesion was biopsied, and pathology was consistent with human papillomavirus-positive (HPV+) SCC. Four cycles of concurrent chemotherapy and radiation for SCC were administered without delay, with an initial response. However, on surveillance, metastases to the brain and lungs were detected, and the patient was placed on palliative treatment as he did not meet eligibility for a clinical trial due to his WM. Concurrent WM and HPV+ SCC may have a worse prognosis, due to disease progression and reduced therapeutic options.
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Affiliation(s)
- Shahm Raslan
- Hematology and Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Mursalin M Anis
- Otolaryngology, University of Miami Miller School of Medicine, Miami, USA
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10
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Macilwraith P, Malsem E, Dushyanthen S. The effectiveness of HPV vaccination on the incidence of oropharyngeal cancers in men: a review. Infect Agent Cancer 2023; 18:24. [PMID: 37095546 PMCID: PMC10127083 DOI: 10.1186/s13027-022-00479-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/27/2022] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Human Papilloma Virus (HPV) contributes to the development of oropharyngeal cancer (OPC) and is currently the leading cause of OPC in the Western world. There have been limited studies examining the effect of HPV-vaccination on OPC incidence in men. This review aims to interrogate relationship linking HPV-vaccination and OPC in men, to potentially recommend pangender HPV-vaccination, to reduce the incidence of HPV associated OPC. MAIN BODY A review was carried out using Ovid Medline, Scopus and Embase databases, on 22nd October 2021 investigating the effect of HPV-vaccination on OPC prevalence in men and including studies with vaccination data pertaining to men in the past 5 years, while excluding those studies without appropriate oral HPV-positivity data and non-systematic reviews. Studies were evaluated as per the PRISMA guidelines and ranked using risk of bias tools including RoB-2, ROBINS-1 and the NIH quality assessment tools. 7 studies were included ranging from original research to systematic review articles. All studies were published in English from 2017 to 2021. Overall, these suggested that HPV-vaccination reduced levels of oral HPV positivity in men. This was thought to be indicative of a reduced risk of development of HPV-associated OPC. A limitation of this study was the inability to conduct meta-analysis due to the heterogeneity of included studies. We noted a significant impact on the reduction of HPV positivity post HPV-vaccination and a potential contribution to reducing the future incidence of OPC. CONCLUSION This review makes a strong case for pangender HPV-vaccination in combatting OPC in men.
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Affiliation(s)
- Philip Macilwraith
- The Prince Charles Hospital, 627 Rode Road, Chermside, QLD, 4032, Australia.
| | - Eve Malsem
- Ballarat Base Hospital, 1 Drummond St North, Ballarat Central, VIC, 3350, Australia
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Vani NV, Madhanagopal R, Swaminathan R, Ganesan TS. Dynamics of oral human papillomavirus infection in healthy population and head and neck cancer. Cancer Med 2023. [PMID: 36846921 DOI: 10.1002/cam4.5686] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 03/01/2023] Open
Abstract
The recent increase in high-risk human papillomavirus (HR-HPV)-associated oral and oropharyngeal cancers has gained considerable importance due to their distinct clinical and molecular characteristics. However, the natural history of oral HPV from acquisition to persistence and malignant transformation is still unclear. The global prevalence of oral HPV infection in healthy individuals ranges from 0.67% to 35%, while 31%-38.5% in head and neck cancer (HNC). The persistence rate of oral HR-HPV infection is 5.5% -12.8% globally. India has the highest HNC burden due to apparent differences in predisposing factors compared with the West. The prevalence of oral HPV in healthy individuals and its contribution to HNC is less evident in Indian studies. HR-HPV-associated HNC in this region accounts for 26%, with an active infection in 8%-15% of these tumors. There is a lack of concordance in the expression of p16 as a surrogate marker for HPV detection in HNC because of differences in behavioral risk factors. Due to a lack of evidence, treatment de-escalation cannot be implemented despite the improved outcome of HPV-associated oropharyngeal cancers. This review critically analyzes the existing literature on the dynamics of oral HPV infection and HPV-associated HNC, identifying potential avenues for future research. A better understanding of the oncogenic role of HR-HPV in HNC will help to formulate novel therapeutic approaches and is expected to have a significant public health impact as preventive strategies can be implemented.
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Affiliation(s)
- N V Vani
- Epidemiology, Biostatistics, and Tumour Registry, Cancer Institute (WIA), Chennai, India
| | - R Madhanagopal
- Epidemiology, Biostatistics, and Tumour Registry, Cancer Institute (WIA), Chennai, India
| | - R Swaminathan
- Epidemiology, Biostatistics, and Tumour Registry, Cancer Institute (WIA), Chennai, India
| | - T S Ganesan
- Medical Oncology, Cancer Institute (WIA), Chennai, India
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Loperfido A, Stasolla A, Giorgione C, Mammarella F, Celebrini A, Acquaviva G, Bellocchi G. Management of Deep Neck Space Infections: A Large Tertiary Center Experience. Cureus 2023; 15:e34974. [PMID: 36938157 PMCID: PMC10019553 DOI: 10.7759/cureus.34974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION Deep neck space infections (DNIs) represent serious bacterial infections affecting the deep cervical space and fascial planes of the neck. This study aims to describe our clinical and surgical experience in the management of DNIs, emphasizing the importance of appropriate imaging in the diagnostic setting and the role of the multidisciplinary approach according to the severity of the infection. METHODS In this retrospective study, we describe 85 patients affected by DNIs coming to the Otolaryngology department observation from the Emergency Room of San Camillo Forlanini Hospital in Rome from January 2006 to December 2021 and treated both by pharmacological and surgical therapy. RESULTS 54 patients (64%) were male, and 31 (36%) were female, with a mean age of 50.5 years. The most common cause of DNI was odontogenic, accounting for 70% of all collected cases. In 68 patients (80% of all cases), the surgical approach consisted of an extended unilateral cervicotomy, whereas in 17 patients (20% of all cases), a bilateral cervicotomy was performed. Surgical revision was required in 15 cases (18%). A tracheostomy was necessary in seven cases. The overall survival rate was 96.5%. CONCLUSIONS DNI represents a serious and life-threatening condition, remaining a constant challenge for the head and neck surgeon. Contrast-enhanced computed tomography is critical for therapeutic planning, which requires both a surgical approach and antibiotic therapy. Surgical treatment should be performed as soon as possible. In severe cases, the multidisciplinary approach is advisable.
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Muacevic A, Adler JR, Pasquale D, Ziegler A. Idiopathic Facial Vein Aneurysm: A Case Report and Review of the Literature. Cureus 2023; 15:e33842. [PMID: 36819344 PMCID: PMC9931438 DOI: 10.7759/cureus.33842] [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] [Accepted: 01/16/2023] [Indexed: 01/17/2023] Open
Abstract
Venous aneurysms of the head and neck, and in particular the facial vein, are rare lesions that present as soft, compressible masses. We describe a case of an idiopathic aneurysm of the facial vein. A comprehensive literature review of this entity was conducted to better understand the disease process. A 51-year-old female presented with a one-year history of a prominent but painless right submandibular mass that was more noticeable with maneuvers such as straining. An exam showed a painless, soft, compressible, right level 1b neck mass that enlarged with Valsalva. A computed tomography scan of the neck revealed a 2.7 cm enhancing mass adjacent to the right submandibular gland. Further workup included a direct puncture venography, which demonstrated an unruptured 3 cm venous aneurysm involving the right facial vein. Surgical excision was offered to the patient, which was completed without complications. Histopathology of the mass was consistent with a facial vein aneurysm and confirmed the suspected diagnosis. The patient was seen postoperatively in follow-up and was healing well. While facial vein aneurysms are rare, it is important to recognize, work up, and treat them appropriately. A painless compressible mass that enlarges with Valsalva is suggestive of the diagnosis. Management may vary on a case-by-case basis with surgical resection being the definitive treatment of choice.
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Ren X, Hao Y, Wu B, Jia X, Niu M, Wang K, Li Z. Efficacy of prophylactic human papillomavirus vaccines on cervical cancer among the Asian population: A meta-analysis. Front Microbiol 2022; 13:1052324. [DOI: 10.3389/fmicb.2022.1052324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/16/2022] [Indexed: 12/04/2022] Open
Abstract
ObjectiveWe conducted a meta-analysis to assess the efficacy of prophylactic human papillomavirus (HPV) vaccines against cervical cancer precursors and HPV persistent infection among Asian populations.MethodsRandomized controlled clinical trials conducted in Asian countries were identified from three electronic databases (PubMed, EMBASE and the Cochrane Library). Publication retrieval was performed on September 1, 2022 and only those written in English were included. The data were analyzed with Cochrane Review Manager (version 5.3) and Stata/SE (15.1). Effect sizes were presented as risk ratios (RRs) and 95% confidence intervals (CIs).ResultsTen articles were considered in the meta-analysis, without significant heterogeneity among them. The fixed-effect RRs and 95% CIs for cervical intraepithelial neoplasia grade 1 (CIN1+) and CIN2+ were 0.10 (0.05–0.21) and 0.11 (0.04–0.27), respectively. Positive effect of HPV vaccination on 6- and 12-month persistent infection were observed, with the respective pooled RRs of 0.05 (95% CI: 0.03–0.09) and 0.09 (95% CI: 0.05–0.15). HPV vaccination has a positive effect on the incidence of cytological abnormalities associated with HPV 16/18 (RR, 0.13; 95% CI (0.09–0.20)). Positive effects of HPV vaccination were also observed for HPV 16- and 18-specific immunogenicity (RR, 235.02; 95% CI (82.77–667.31) and RR, 98.24; 95% CI (50.36–191.67), respectively). Females receiving an initial vaccination showed significant decreased incidences of cervical intraepithelial neoplasia, HPV persistent infection and cytological abnormalities and a significantly higher antibody positive conversion rate compared with non-vaccination counterparts.ConclusionProphylactic HPV vaccines are highly efficacious in preventing cervical cancer in Asian females. The government should accelerate the processes of vaccine introduction and vaccination implementation by prioritizing them in public health policies, which should be helpful to enhance Asian females’ awareness of receiving HPV vaccination volitionally.
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Muacevic A, Adler JR, Sayed Z. Perifacial Lymph Node Metastasis After Treatment of Oropharyngeal Primary Malignancy: A Case Report. Cureus 2022; 14:e31332. [PMID: 36514564 PMCID: PMC9741130 DOI: 10.7759/cureus.31332] [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] [Accepted: 11/10/2022] [Indexed: 11/12/2022] Open
Abstract
With the rate of oropharyngeal cancer on the rise, appropriate surgical management is an increasingly important consideration. Much debate currently exists regarding the necessary extent of neck dissections when performing curative surgery for primary oropharyngeal malignancies. Here, we present the case of a 64-year-old patient with p16+ T1N1M0 squamous cell carcinoma (SCC) of the right tonsil. Approximately four years following transoral robotic surgery oropharyngectomy and ipsilateral level II-IV right selective neck dissection, metastatic SCC was discovered on fine-needle aspiration biopsy of a right perifacial lymph node (level Ib). The patient then underwent a revision right neck dissection at levels Ia and Ib. Adjuvant immunotherapy was recommended following revision neck dissection. Postoperative imaging and flexible laryngoscopy three months after surgery were not concerning for cervical lymphadenopathy or oropharyngeal lesions. Although rare, physicians must maintain a healthy level of suspicion for recurrence to level Ib in oropharyngeal primary malignancies.
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Gebril MAB, Mukhtar WNO, Elhassan MMA, Mahmoud I. Incidence Characteristics and Histological Types of Head and Neck Cancer among Adults in Central Sudan: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13814. [PMID: 36360694 PMCID: PMC9656960 DOI: 10.3390/ijerph192113814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Head and neck cancers (HNCs) are prevalent in Sudan, but the reasons for this and the incidence of different types of HNCs are not well understood. A cross-sectional retrospective study was conducted to provide baseline data on the epidemiology of HNCs among patients treated at the National Cancer Institute (NCI) in central Sudan. All cancer cases from 2016 to 2020 were retrieved from the NCI records. Of the 9475 new cancer patients who were registered at the NCI during the study period, 1033 (11%) had HNCs, of whom 767 (74.2%) were adults. The mean age of the adult patients was 54.5 years (standard deviation 15.8) and 449 (58.5%) patients were male. The annual incidence in adults was 4/105 population. The most common HNC sites were the nasopharynx (25.3%), hypopharynx (22.8%), and oral cavity (22.2%). Carcinoma was the most common diagnosis (87.6%), followed by lymphoma (5.6%). Most patients' tumors were at a locally advanced (22%) or metastatic stage (47%) of HNCs at the time of presentation. Further studies to identify risk factors for HNCs, particularly for the most prevalent types in central Sudan, are needed. In addition, Sudan requires capacity building for cancer, including a national cancer registry.
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Affiliation(s)
| | - Wail Nuri Osman Mukhtar
- Department of Surgery, Faculty of Medicine, University of Gezira, Wad Medani P.O. Box 20, Sudan
| | | | - Ibrahim Mahmoud
- Department of Family and Community Medicine and Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
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HPV Vaccination: An Underused Strategy for the Prevention of Cancer. Curr Oncol 2022; 29:3780-3792. [PMID: 35621693 PMCID: PMC9140027 DOI: 10.3390/curroncol29050303] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/28/2022] [Accepted: 05/13/2022] [Indexed: 01/08/2023] Open
Abstract
Human papillomavirus (HPV) vaccination prevents cervical, head and neck, and anogenital cancers. However, global HPV vaccine coverage falls short of global targets and has seen unexpected and dramatic declines in some countries. This paper synthesizes the impact of HPV on the global burden of cancer and the potential benefit of HPV vaccination. Approximately 5% of the world’s cancers are specifically attributed to HPV. While the greatest global burden of HPV is cervical cancers in low- and middle-income countries, HPV-associated head and neck cancers are increasing in high-income countries and have surpassed cervical cancer as the primary HPV-associated cancer in some countries. Therefore, it is also critical to improve gender-neutral HPV vaccination. Understanding the modifiable drivers of vaccine acceptance and uptake is important for increasing HPV vaccination. The Behavioural and Social Drivers of Vaccination framework is broadly applied to identify key factors associated with HPV vaccination including domains concerning practical issues, motivation, social processes, and thinking and feeling. Among the behavioural strategies available to reduce the incidence and mortality of cancer, increasing HPV vaccination stands out as having unrealized potential to prevent disease, financial cost, and psychological distress. An understanding of the shifting burden of HPV and the factors associated with vaccination can be leveraged to regularly measure these factors, develop interventions to promote vaccine uptake, and improve global HPV vaccine coverage. Future research in diverse contexts is necessary to investigate the barriers and facilitators of global HPV vaccination.
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Browne S, Feemster KA. Human papillomavirus: optimizing opportunities for prevention. Curr Opin Pediatr 2022; 34:132-139. [PMID: 35152231 DOI: 10.1097/mop.0000000000001119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Human papillomavirus (HPV) infection is one of the most common sexually transmitted infections worldwide and is a precursor to anogenital and oropharyngeal cancers. Effective prevention is available through HPV vaccination and emerging evidence demonstrates the potential to significantly impact HPV-associated disease through reductions in the incidence of genital warts, precancerous cervical lesions, and cervical cancer. Indications have also recently expanded to include the prevention of oropharyngeal cancer, an outcome that has been increasing in incidence for men and women. Yet despite demonstrated effectiveness, the potential for broader impact and well-established routine recommendations for administration to adolescents, barriers to vaccine uptake persist. The purpose of this review is to provide an update on HPV prevention in the US, including trends in disease burden, HPV vaccine effectiveness, evolving vaccine recommendations and opportunities and barriers to their implementation. RECENT FINDINGS Several studies have demonstrated that HPV vaccination has the potential to prevent most HPV-attributable cancers. Ongoing research addresses questions related to duration of protection, effectiveness in vulnerable populations, vaccine schedules and strategies to improve access and optimize uptake. SUMMARY To ensure continued impact on the prevention of HPV-associated disease and subsequent cancer, it is crucial to address gaps in vaccine uptake. A strong recommendation for all persons for whom HPV vaccines are indicated, alongside initiatives to increase awareness of HPV vaccination and address specific concerns, can improve uptake among hesitant populations. Globally, efforts to bolster immunization programs are needed to broaden access to HPV vaccination.
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Affiliation(s)
- Safa Browne
- Vaccine Education Center, The Children's Hospital of Philadelphia
| | - Kristen A Feemster
- Vaccine Education Center, The Children's Hospital of Philadelphia
- Department of Pediatrics, Division of Infectious Disease, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Global Medical and Scientific Affairs, Merck Research Laboratories, Merck & Co., Inc., Kenilworth, New Jersey, USA
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Bovbjerg ML, Horan H. Current Resources for Evidence-Based Practice, January 2022. J Obstet Gynecol Neonatal Nurs 2021; 51:101-112. [PMID: 34921766 DOI: 10.1016/j.jogn.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of breastfeeding while employed and commentaries on reviews focused on mammography test characteristics and sexual health for gynecologic cancer survivors. It also includes a quick update on a USPSTF review for aspirin as pre-eclampsia prophylaxis.
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