1
|
G SN, Sssn R, Chaturvedula L, Adole P. Deoxyribose Nucleic Acid Damage and Its Association With Plasma Malondialdehyde Levels Among Patients With Cervical Cancer: A Case-Control Study. Cureus 2024; 16:e52600. [PMID: 38374844 PMCID: PMC10875276 DOI: 10.7759/cureus.52600] [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: 01/19/2024] [Indexed: 02/21/2024] Open
Abstract
Purpose The objective of this research project was to estimate DNA damage in patients diagnosed with cervical cancer using the comet assay, establish a correlation between this quantification and the oxidative stress marker malondialdehyde (MDA; plasma MDA), and compare the resulting parameters between the cases and age-matched controls. Materials and methods This study included 49 cervical cancer cases and 49 age-matched controls to measure DNA damage parameters such as comet length, head diameter, percentage of DNA in the comet head, tail length, percentage of DNA in the comet tail, and oxidative stress marker (plasma MDA) using the thiobarbituric acid reactive substance (TBARS) enzyme-linked immunosorbent assay (ELISA) method. Results Comet metrics suggesting DNA damage, such as comet length, tail length, and percentage of DNA in the comet tail, were considerably higher in cervical cancer cases than in age-matched controls. The proportion of DNA in the comet head, representing undamaged/mild DNA damage, was significantly higher in age-matched controls than in cervical cancer patients. Plasma MDA and comet tail length were shown to have a positive correlation. Compared to the age-matched controls, those between the ages of 30 and 39, with a parity of two to four, who had a history of early age at first pregnancy and a positive family history of cervical cancer, had the highest level of DNA damage. Conclusion The elevated levels of comet parameters and their positive correlation with plasma MDA suggest that individuals diagnosed with cervical cancer have a higher degree of DNA damage compared to the control group. In conjunction with established methods like the PAP smear, this predictive test comprising comet assay and estimation of plasma MDA may be utilized to identify and assess the risk of cervical cancer in individuals aged 30-39 years, with a parity between two and four pregnancies and a prior history of early age at first pregnancy, accompanied by a positive family history of the disease.
Collapse
Affiliation(s)
| | - Rajasekhar Sssn
- Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Latha Chaturvedula
- Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Prashant Adole
- Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| |
Collapse
|
2
|
Alkhamis FH, Alabbas ZAS, Al Mulhim JE, Alabdulmohsin FF, Alshaqaqiq MH, Alali EA. Prevalence and Predictive Factors of Cervical Cancer Screening in Saudi Arabia: A Nationwide Study. Cureus 2023; 15:e49331. [PMID: 38143659 PMCID: PMC10748848 DOI: 10.7759/cureus.49331] [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: 11/24/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Cervical cancer, despite being preventable, is one of the most prevalent cancers among females globally and in Saudi Arabia. The literature demonstrated that, unlike global trends, cervical cancer incidence in Saudi Arabia is increasing. In addition to that, a high proportion of it is discovered in advanced stages. This state of late discovery was attributed to the absence of efficient preventive and screening programs. Observing the scale of the preventable morbidities and mortalities that can be caused by cervical cancer and the efforts and costs that are positioned to fight cervical cancer across the globe and the current ambiguity in the cervical cancer screening prevalence in Saudi Arabia brings the realization of the importance of conducting a study that properly explores the status of cervical cancer screening in Saudi Arabia. AIM This study aims to measure the prevalence and the predictive factors for cervical cancer screening among adult women who were previously sexually active in Saudi Arabia, as well as explore the participants' knowledge and attitude toward cervical cancer and human papillomavirus (HPV) vaccines. METHODS This study was a nationwide cross-sectional study conducted in Saudi Arabia between September 2023 and November 2023 on adult Saudi females between the ages of 21 and 65 years who were previously sexually active and did not undergo a hysterectomy. Data were collected through a convenience sampling technique where a self-administered survey was established and disseminated to the targeted population all over the country with the assistance of data collectors. Cervical cancer screening prevalence and screening predictive factors were measured. Factors associated with cervical cancer screening and knowledge of cervical cancer were tested using a chi-square test, an independent t-test, and an ANOVA test. Multivariate logistic regression was also used to determine predictors of cervical cancer screening. RESULTS The study included 2,337 participants. The prevalence of cervical cancer screening among Saudi females was observed to be 22.1%. The most commonly reported reason for not undergoing cervical cancer screening was that it was never recommended by a physician, as reported by 42.4%. Only 7.6% reported taking the HPV vaccine. The majority of the participants (84.1%) had a low knowledge level about cervical cancer. The multivariate logistic regression model revealed that the following factors were observed to be significantly predictive of undergoing cervical cancer screening: being 46-59 years of age (74% increase rate), having an income greater than 20,000 Saudi Riyals (SRs) (158% increase rate), having a history of gynecological problems (152% increase rate), knowing someone who underwent cervical cancer screening (393% increase rate), and receiving a recommendation from a healthcare practitioner to undergo cervical cancer screening (1300% increase rate). CONCLUSION There are clearly low rates of cervical cancer screening and even lower rates of uptake for the HPV vaccine, which are the prevention measures for cervical cancer. National initiatives and programs that promote HPV vaccine uptake and regular cervical cancer screening are highly recommended to minimize the morbidity and mortality of cervical cancer.
Collapse
Affiliation(s)
| | | | | | | | | | - Eithar A Alali
- Obstetrics and Gynaecology, King Faisal University, Alhofuf, SAU
| |
Collapse
|
3
|
Li S, Li X, Zhang S, Feng Y, Jia T, Zhu M, Fang L, Gong L, Dong S, Kong X, Wang Z, Sun L. Association Between GSDMB Gene Polymorphism and Cervical Cancer in the Northeast Chinese Han Population. Front Genet 2022; 13:860727. [PMID: 35832190 PMCID: PMC9271821 DOI: 10.3389/fgene.2022.860727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: The purpose of this study was to investigate the relationship between GSDMB gene polymorphism and genetic susceptibility to cervical cancer in the Han population in Northeast China. Methods: In this case-control study, the genotypes and alleles of rs8067378 in the GSDMB gene were analyzed by multiplex polymerase chain reaction (PCR) and next-generation sequencing methods in 482 cervical cancer (CC) patients, 775 cervical squamous intraepithelial lesion (SIL) patients, and 495 healthy women. The potential relationships between the SNP of the GSDMB gene with SIL and CC were analyzed by multivariate logistic regression analysis combined with 10,000 permutation tests. Results: In the comparison between the SIL group and the control group, the genotype and allele distribution frequencies of rs8067378 SNP of the GSDMB gene were statistically significant (p = 0.0493 and p = 0.0202, respectively). The allele distribution frequencies of rs8067378 were also statistically significant in the comparison between high-grade cervical squamous intraepithelial lesion (HSIL) and low-grade cervical squamous intraepithelial lesion (LSIL) groups with control group ( p = 0.0483 and p = 0.0330, respectively). Logistic regression analysis showed that after adjusting for age, the rs8067378 SNP of the GSDMB gene was significantly associated with the reduced risk of SIL under the dominant model (p = 0.0213, OR = 0.764, CI = 0.607-0.961) and the additive model (p = 0.0199, OR = 0.814, and CI = 0.684-0.968), and its mutant gene G may play a role in the progression of healthy people to LSIL and even HSIL as a protective factor. However, there was no significant association between cervical cancer and its subtypes with the control group (p > 0.05). After 10,000 permutations, there was still no correlation that has provided evidence for the accuracy of our study. Conclusion: The results of this study showed that rs8067378 single nucleotide polymorphism of the GSDMB gene may reduce the risk of SIL and protect the susceptibility to cervical precancerous lesions in the Northeast Chinese Han population, but it has no significant correlation with the progression of cervical cancer.
Collapse
Affiliation(s)
- Songxue Li
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital, Hangzhou, China
| | - Xiaoying Li
- Department of Ultrasound, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shuang Zhang
- Department of Ultrasound, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yanan Feng
- Department of Ultrasound, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tianshuang Jia
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital, Hangzhou, China
| | - Manning Zhu
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital, Hangzhou, China
| | - Lei Fang
- Department of Ultrasound, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Liping Gong
- Department of Ultrasound, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shuang Dong
- Department of Ultrasound, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xianchao Kong
- Department of Obstetrics and Gynecology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhenzhen Wang
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital, Hangzhou, China
| | - Litao Sun
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital, Hangzhou, China
| |
Collapse
|
4
|
Chekin N, Ayatollahi H, Karimi Zarchi M. A Clinical Decision Support System for Assessing the Risk of Cervical Cancer: Development and Evaluation Study. JMIR Med Inform 2022; 10:e34753. [PMID: 35731549 PMCID: PMC9260527 DOI: 10.2196/34753] [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: 11/06/2021] [Revised: 02/05/2022] [Accepted: 02/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Cervical cancer has been recognized as a preventable type of cancer. As the assessment of all the risk factors of a disease is challenging for physicians, information technology and risk assessment models have been used to estimate the degree of risk. Objective The aim of this study was to develop a clinical decision support system to assess the risk of cervical cancer. Methods This study was conducted in 2 phases in 2021. In the first phase of the study, 20 gynecologists completed a questionnaire to determine the essential parameters for assessing the risk of cervical cancer, and the data were analyzed using descriptive statistics. In the second phase of the study, the prototype of the clinical decision support system was developed and evaluated. Results The findings revealed that the most important parameters for assessing the risk of cervical cancer consisted of general and specific parameters. In total, the 8 parameters that had the greatest impact on the risk of cervical cancer were selected. After developing the clinical decision support system, it was evaluated and the mean values of sensitivity, specificity, and accuracy were 85.81%, 93.82%, and 91.39%, respectively. Conclusions The clinical decision support system developed in this study can facilitate the process of identifying people who are at risk of developing cervical cancer. In addition, it can help to increase the quality of health care and reduce the costs associated with the treatment of cervical cancer.
Collapse
Affiliation(s)
- Nasrin Chekin
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Mojgan Karimi Zarchi
- Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Kanjanawilai N, Wisarnsirirak P, Chanthasenanont A, Pattaraarchachai J, Suwannarurk K. Knowledge Attitude and Practice of Postpartum Parturients Towards Cervical Cancer and Cervical Cancer Screening; Is Lack of Knowledge the Misleading Scapegoat? Asian Pac J Cancer Prev 2022; 23:2145-2150. [PMID: 35763659 PMCID: PMC9587818 DOI: 10.31557/apjcp.2022.23.6.2145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVE The aim of this study was to assess knowledge, attitude, and practices towards cervical cancer screening among postpartum subjects. STUDY DESIGN This cross-sectional study was conducted at inpatient obstetrics ward at Thammasat University Hospital (TUH), Thailand. The period of study was between July 2020 and July 2021. Subjects were term Thai pregnant women who had age between 20 and 45 years old and delivered at TUH. Demographic characters, knowledge, attitude and practices regarding cervical cancer screening were collected. RESULTS A total of 388 parturient was recruited into the study. Average age was 31 years old. Around 90 percent of subjects knew that every woman age between 21and 65 years old with or without children should be screened for cervical cancer despite having only 46.6 percent (181/388) of subjects that underwent postpartum cervical cancer screening. Almost half of the participant agreed that risky sexual behavior of both genders was not the cause of cervical cancer. Despite the availability of the HPV vaccine throughout the country, only 74.2 percent acknowledged that HPV was the cause and only 70.4% heard about the HPV vaccine. The mean attitude about the cervical cancer was relatively high with the mean of 3.19±0.46. Although the higher the score the better the attitude toward the statement, there were several correlations of having such attitude. CONCLUSION Attention to postpartum cervical cancer screening was quite low even though high knowledge of cervical cancer and screening. Scant knowledge was not all of the troubles that we believed long time ago.
Collapse
|
6
|
Pham MA, Benkortbi K, Kenfack B, Tincho Foguem E, Sormani J, Wisniak A, Lemoupa Makajio S, Manga E, Vassilakos P, Petignat P. Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon. BMC Public Health 2022; 22:548. [PMID: 35305588 PMCID: PMC8933918 DOI: 10.1186/s12889-022-12951-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 02/17/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives The World Health Organization’s (WHO) global strategy for cervical cancer elimination has set the target of 70% of women screened in all countries by 2030. Community sensitization through media is often used, but community health workers’ (CHW) involvement may contribute to improving screening coverage. We aimed to assess effectiveness and costs of two cervical cancer screening recruitment strategies conducted in a low-resource setting. Methods The study was conducted in the West Region of Cameroon, in the Health District of Dschang, a community of 300,000 inhabitants. From September 2018 to February 2020, we recruited and screened women for cervical cancer in a single-visit prevention campaign at Dschang District Hospital. During the first 9 months, recruitment was only based on Community Information Channels (CIC) (e.g.. street banners). From the tenth month, participation of CHW was added in the community after training for cervical cancer prevention counselling. Population recruitment was compared between the two strategies by assessing the number of recruited women and direct costs (CHW costs included recruitment, teaching, certification, identification badge, flyers, transport, and incentives). The intervention’s cost-effectiveness was expressed using an incremental cost-effectiveness ratio (ICER). Results and discussion During the period under study, 1940 women were recruited, HPV positive rate was 18.6% (n = 361) and 39 cases of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were diagnosed. Among included participants, 69.9% (n = 1356) of women were recruited through CIC as compared to 30.1% (n = 584) by CHW. The cost per screened woman and CIN2+ diagnosed was higher in the CHW group. The ICER was 6.45 USD or 16.612021Int’l$ per screened woman recruited by CHW. Recruitment in rural areas increased from 12.1 to 61.4% of all women included between CIC-led and CHW-led interventions. These outcomes highlight the importance of training, preparing, and deploying CHW to screen hard-to-reach women, considering that up to 45% of Cameroon’s population lives in rural areas. Conclusion CHW offer an important complement to CIC for expanding coverage in a sub-Saharan African region such as the West Region of Cameroon. CHW play a central role in building awareness and motivation for cervical cancer screening in rural settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12951-1.
Collapse
|
7
|
Awareness and Practices Related to Cervical Cancer among Females in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031455. [PMID: 35162471 PMCID: PMC8835229 DOI: 10.3390/ijerph19031455] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 12/10/2022]
Abstract
Human papilloma virus (HPV) is the most common risk factor for cervical cancer. Cervical cancer can be prevented with vaccination and early screening methods using pap smears. However, the acceptance of these approaches can be affected by the awareness level of the population. This cross-sectional study aimed to assess knowledge and practices related to cervical cancer among women in the Al Madinah Province in Saudi Arabia. A total of 1489 responses were included in the analysis. The median awareness score related to cervical cancer was eight out of 20 points. Vaginal bleeding, dyspareunia, and leg pain were correctly identified by 79.8%, 43.7%, and 19.3% of the women, respectively. Thirty-four percent of the study sample knew that the sexually transmitted virus is a risk factor for cervical cancer. Only 44.6% were able to correctly identify pap smear as a screening tool, and 12.6% knew that there was a HPV vaccine. This study revealed a low to moderate awareness level toward cervical cancer, pap smear, and HPV vaccine. Thus, awareness campaigns are urgently needed to increase the awareness level for early detection and prevention of the disease.
Collapse
|
8
|
Alam NE, Islam MS, Rayyan F, Ifa HN, Khabir MIU, Chowdhury K, Mohiuddin AKM. Lack of knowledge is the leading key for the growing cervical cancer incidents in Bangladesh: A population based, cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000149. [PMID: 36962139 PMCID: PMC10021366 DOI: 10.1371/journal.pgph.0000149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 12/07/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cervical cancer is the second most common gynecological cancer in Bangladesh. Lack of awareness of screening methods, risk factors, and symptoms may lead to presenting most cervical cancers at an advanced stage. We investigated knowledge and awareness of cervical cancer (CCa) among females at the Sheikh Hasina Medical College (SHMC) of Tangail district in Bangladesh. METHODS A cross sectional survey was conducted to collect data via a structured questionnaire from SHMC during the period of February 2019 to January 2020. Data on socio-demographic characteristics and knowledge of cervical cancer were collected. Multivariable logistic regression models were used to identify factors associated with having heard and knowledge of cervical cancer. A p-value <0.05 was considered significant. RESULT Of all the interviews conducted, only 45.2% (493/1090) had heard of cervical cancer as a disease. Women were more likely to be aware of CCa if they were lived in urban areas, had higher education (university level education) and belong to high income families. The study revealed evidence of significant association between marital, literacy, residence and socio-economic status with women's knowledge on cervical cancer (p< 0.05). CONCLUSION This study serves to highlight that there was impoverished knowledge about cervical cancer among Bangladeshi women. Hence, this indicates the government should take proper steps to raise awareness and knowledge levels via educational programs and health counseling.
Collapse
Affiliation(s)
- Nur E Alam
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Md Shariful Islam
- Department of Biology, University of Kentucky, Lexington, KY, United States of America
| | - Fabia Rayyan
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Humaira Nur Ifa
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Md Imam Ul Khabir
- Department of Biological Science, Alabama State University, Montgomery, AL, United States of America
| | - Kamal Chowdhury
- Department of Biology, Claflin University, Orangeburg, SC, United States of America
| | - A K M Mohiuddin
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| |
Collapse
|
9
|
Liberacka-Dwojak M, Izdebski P. Sexual Function and the Role of Sexual Communication in Women Diagnosed with Cervical Cancer: A Systematic Review. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 33:385-395. [PMID: 38595751 PMCID: PMC10903643 DOI: 10.1080/19317611.2021.1919951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/15/2021] [Accepted: 04/16/2021] [Indexed: 04/11/2024]
Abstract
The objective of this systematic review was to summarize the changes in sexual function in cervical cancer survivors. The additional objective was to exhibit the role of sexual communication in adapting to these changes. A systematic search was performed across four electronic databases. Eighteen studies met the inclusion criteria. The most common sexual dysfunction was pain during sexual intercourse, vaginal dryness, decreased level of satisfaction and sexual interest. Some changes in vaginal anatomy and effects on psychosocial functioning were described. We confirmed that sexual communication with healthcare professionals and partners may be essential to help improve sexuality in CC survivors.
Collapse
Affiliation(s)
| | - Paweł Izdebski
- Faculty of Psychology, Kazimierz Wielki University, Bydgoszcz, Poland
| |
Collapse
|
10
|
Adedimeji A, Ajeh R, Pierz A, Nkeng R, Ndenkeh JJ, Fuhngwa N, Nsame D, Nji M, Dzudie A, Anastos KM, Castle PE. Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context. BMC WOMENS HEALTH 2021; 21:74. [PMID: 33602194 PMCID: PMC7890622 DOI: 10.1186/s12905-021-01211-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/04/2021] [Indexed: 01/26/2023]
Abstract
Background Cervical cancer is a leading cause of death among Cameroon women. The burden of cervical cancer is in part traceable to the inadequate understanding of socio-contextual determinants of access to screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical cancer prevention in women at risk in a low-income, high HIV prevalence context. Methods We utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews from May to August, 2018. A two-stage purposive sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided data analyses to identify micro-, meso-, and macro-level determinants of cervical cancer screening. Results Micro-level factors including lack of awareness and knowledge about cervical cancer, lack of access to information, excessive cost of cervical cancer screening, low risk perceptions, and poor health seeking behaviors were major barriers for women seeking cervical cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Macro-level barriers to cervical cancer screening included poorly equipped health facilities and a lack of national cancer prevention policies and programs. Conclusion In the context of the call for elimination of cervical cancer as a public health problem, our findings highlight challenges and opportunities that should be considered when implementing interventions to increase uptake of cervical cancer screening in low-middle income settings.
Collapse
Affiliation(s)
- Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
| | - Rogers Ajeh
- Clinical Research Education, Networking and Consultancy, Yaoundé, Cameroon
| | - Amanda Pierz
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Relindis Nkeng
- Clinical Research Education, Networking and Consultancy, Yaoundé, Cameroon
| | - Jackson Jr Ndenkeh
- Clinical Research Education, Networking and Consultancy, Yaoundé, Cameroon.,Center for International Health, Ludwig Maximillian University of Munich, Munich, Germany
| | - Norbert Fuhngwa
- Clinical Research Education, Networking and Consultancy, Yaoundé, Cameroon
| | - Denis Nsame
- Limbe Regional Hospital, Limbe, Southwest Region, Cameroon
| | - Miriam Nji
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anastase Dzudie
- Clinical Research Education, Networking and Consultancy, Yaoundé, Cameroon
| | - Kathryn M Anastos
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Philip E Castle
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| |
Collapse
|
11
|
Morhason-Bello IO, Kareem YO, Adewole IF. Modeling for Predictors of Knowledge Score on Etiology and Prevention Strategies for Cervical Cancer Among Women of Reproductive Age in Ibadan. JCO Glob Oncol 2020; 6:892-903. [PMID: 32589467 PMCID: PMC7328104 DOI: 10.1200/go.20.00086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Poor knowledge regarding cervical cancer in at-risk populations directly affects health-seeking behavior and is associated with high mortality among women with cervical cancer. This study aims to evaluate the knowledge of women regarding the causes, risk factors, and prevention strategies of cervical cancer. METHODS A multistage cross-sectional study of 1,002 women of reproductive age (18-49 years) in Ibadan was conducted. Knowledge of cervical cancer risk causes and prevention strategies was assessed using 13 and 9 question items, respectively. The knowledge score was graded as 0 (no knowledge), 1-4 (poor knowledge), or ≥ 5 (good knowledge). The proportional or partial proportional odds model was used to fit 3 models using the forward stepwise selection. All analysis was performed using Stata 15.0 (Stata Corp, College Station, TX). RESULTS The median age of participants was 29 years (interquartile range [IQR], 23-35 years). The median knowledge scores of participants on causes and prevention strategies of cervical cancer were 3 (IQR, 0-4) and 3 (IQR, 0-5), respectively. The assessment of knowledge on causes and prevention strategies for cervical cancer revealed that having multiple sexual partners and no previous opportunity for counseling on cervical cancer screening were factors associated with lower odds of knowledge. CONCLUSION The knowledge of women about the risk factors, causes, and prevention strategies of cervical cancer was poor. It is worrisome that poor knowledge was common among women with potential demographic risk factors for cervical cancer. We recommend innovative community mobilization to improve women’s knowledge of the risk factors associated with cervical cancer and prevention strategies.
Collapse
Affiliation(s)
- Imran O Morhason-Bello
- Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Institute of Advanced Medical Research and Training, College of Medicine, University of Ibadan, Nigeria
| | - Yusuf Olushola Kareem
- Institute of Advanced Medical Research and Training, College of Medicine, University of Ibadan, Nigeria.,Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Isaac F Adewole
- Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
12
|
Chien HJ, Ying TH, Hsieh SC, Lin CL, Yu YL, Kao SH, Hsieh YH. α-Mangostin attenuates stemness and enhances cisplatin-induced cell death in cervical cancer stem-like cells through induction of mitochondrial-mediated apoptosis. J Cell Physiol 2020; 235:5590-5601. [PMID: 31960449 DOI: 10.1002/jcp.29489] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 01/09/2020] [Indexed: 12/27/2022]
Abstract
Cancer stem cells (CSCs) exhibit specific characteristics including decontrolled self-renewal, tumor-initiating, promoting, and metastatic potential, abnormal stemness signaling, and chemotherapy resistance. Thus, targeting CSC is becoming an emerging cancer treatment. α-Mangostin has been shown to have potent and multiple anticancer activities. Accordingly, we hypothesized that α-mangostin may diminish the stemness and proliferation of CSC-like cervical cancer cells. In our results, comparing to the parent cells, CSC-like SiHa and HeLa cells highly expressed CSC marker Sox2, Oct4, Nanog, CK-17, and CD49f. α-Mangostin significantly reduced the cell viability, sphere-forming ability, and expression of the CSC stemness makers of CSC-like cervical cancer cells. Further investigation showed that α-mangostin induced mitochondrial depolarization and mitochondrial apoptosis signaling, including upregulation of Bax, downregulation of Mcl-1 and Bcl-2, and activation of caspase-9/3. Moreover, α-mangostin synergically enhanced the cytotoxicity of cisplatin on CSC-like SiHa cells by promoting mitochondrial apoptosis and inhibiting the expression of CSC markers. Consistent with in vitro findings, in vivo tumor growth assay revealed that α-mangostin administration significantly inhibited the growth of inoculated CSC-like SiHa cells and synergically enhanced the antitumor effect of cisplatin. Our findings indicate that α-mangostin can reduce the stemness and proliferation of CSC-like SiHa and HeLa cells and promote the cytotoxicity of cisplatin, which may attribute to the mitochondrial apoptosis activation. Thus, it suggests that α-mangostin may have clinical potential to improve chemotherapy for cervical cancer by targeting cervical CSC.
Collapse
Affiliation(s)
- Hung-Ju Chien
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Tsung-Ho Ying
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Department of Obstetrics and Gynecology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shu-Ching Hsieh
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chia-Liang Lin
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
| | - Yung-Luen Yu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,Center for Molecular Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Biotechnology, Asia University, Taichung, Taiwan
| | - Shao-Hsuan Kao
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan.,Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Hsien Hsieh
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan.,Department of Biochemistry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| |
Collapse
|