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Scott-Williams J, Hosein A, Akpaka P, Adidam Venkata CR. Epidemiology of Cervical Cancer in the Caribbean. Cureus 2023; 15:e48198. [PMID: 38054120 PMCID: PMC10694396 DOI: 10.7759/cureus.48198] [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: 11/02/2023] [Indexed: 12/07/2023] Open
Abstract
Cervical cancer (CvC) is considered a preventable disease; however, in the Caribbean, it is still one of the fourth most common causes of death in women. Efforts to overcome obstacles to the treatment and control of this preventable disease are being made by several countries within the Caribbean. However, no health issue can be readily managed without first acquiring an understanding of the dynamics relating to its severity of impact reaching the target population, its clinical pathology, and the availability of treatment and/or preventative measures to control or halt its progression. To assess the status of CvC in the Caribbean, a review of the literature was conducted using PubMed. The Caribbean was defined in the review as comprising nations and islands whose coastlines are touched by the Caribbean Sea. This led to an assessment of the available literature on CvC for 33 Caribbean territories. The review showed a lack of published information on CvC and highlights the need for greater research. This also serves as a template for subsequent investigations.
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Affiliation(s)
- Jamie Scott-Williams
- Biomedical Engineering, The University of Trinidad and Tobago, Port of Spain, TTO
| | - Amalia Hosein
- Biomedical Engineering, The University of Trinidad and Tobago, Port of Spain, TTO
| | - Patrick Akpaka
- Pathology/Microbiology, The University of the West Indies, St. Augustine, TTO
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McFarlane SJ, Morgan SE, Carcioppolo N. Lessons learned from the “Goodie Box”: A message design study developed and evaluated in community settings for cervical cancer prevention. Front Oncol 2022; 12:935704. [PMID: 36158662 PMCID: PMC9492837 DOI: 10.3389/fonc.2022.935704] [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] [Received: 05/04/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Despite the availability of free pap testing services, Jamaican women have low human papillomavirus (HPV) screening rates; 16% of women in the Kingston Metropolitan Area have been screened within the prior 3 years. This paper discusses the testing of theory-based messages to increase HPV screening uptake in a low-resource setting, using HPV self-test kits designed for this intervention. A total of 163 Jamaican women, aged 30–65 years, who had not had a pap test in at least 3 years, from two low socioeconomic status communities in Kingston, were enrolled and assigned to one of two versions of an HPV self-test kit, either with or without culturally targeted fear appeal messages. The uptake of screening was high across conditions; 95.6% of participants used the HPV self-test and returned their kits. However, surprising variations were observed in self-test acceptability, explained by differing attitudes toward the message conditions. Based on the results, we recommend four key components to increase HPV screening in low-resource settings: 1) focus on perceived threat in message design, 2) avoid written materials due to literacy concerns, 3) use culturally appropriate interpersonal or community-based channels, and 4) consider alternative solutions (such as a self-test) available at no or low cost to address structural barriers.
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Moise RK, Balise R, Ragin C, Kobetz E. Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida. PLoS One 2021; 16:e0254089. [PMID: 34228766 PMCID: PMC8259954 DOI: 10.1371/journal.pone.0254089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 06/18/2021] [Indexed: 11/19/2022] Open
Abstract
Although decreasing rates of cervical cancer in the U.S. are attributable to health policy, immigrant women, particularly Haitians, experience disproportionate disease burden related to delayed detection and treatment. However, risk prediction and dynamics of access remain largely underexplored and unresolved in this population. This study seeks to assess cervical cancer risk and access of unscreened Haitian women. Extracted and merged from two studies, this sample includes n = 346 at-risk Haitian women in South Florida, the largest U.S. enclave of Haitians (ages 30–65 and unscreened in the previous three years). Three approaches (logistic regression [LR]; classification and regression trees [CART]; and random forest [RF]) were employed to assess the association between screening history and sociodemographic variables. LR results indicated women who reported US citizenship (OR = 3.22, 95% CI = 1.52–6.84), access to routine care (OR = 2.11, 95%CI = 1.04–4.30), and spent more years in the US (OR = 1.01, 95%CI = 1.00–1.03) were significantly more likely to report previous screening. CART results returned an accuracy of 0.75 with a tree initially splitting on women who were not citizens, then on 43 or fewer years in the U.S., and without access to routine care. RF model identified U.S. years, citizenship, and access to routine care as variables of highest importance indicated by greatest mean decreases in Gini index. The model was .79 accurate (95% CI = 0.74–0.84). This multi-pronged analysis identifies previously undocumented barriers to health screening for Haitian women. Recent US immigrants without citizenship or perceived access to routine care may be at higher risk for disease due to barriers in accessing U.S. health-systems.
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Affiliation(s)
- Rhoda K. Moise
- Patient Centered Care and Education, Research, Education, and Social Solutions, Inc. (REESSI), Hampton, Virginia, United States of America
- * E-mail:
| | - Raymond Balise
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Camille Ragin
- Department of Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States of America
| | - Erin Kobetz
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
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Vos RA, Pasmans H, Tymchenko L, Janga-Jansen AVA, Baboe-Kalpoe S, Hulshof K, de Melker HE, van der Klis FRM. High seroprevalence of multiple high-risk human papillomavirus types among the general population of Bonaire, St. Eustatius and Saba, Caribbean Netherlands. Vaccine 2020; 38:2816-2826. [PMID: 32088019 DOI: 10.1016/j.vaccine.2020.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Incidence and mortality of human papillomavirus (HPV)-related cancers differs geographically, with high rates in Caribbean countries. Seroepidemiological data provide information on lifetime cumulative HPV exposure and contributing risk factors, but has not been available yet for Caribbean Netherlands (CN), comprising the islands Bonaire, St. Eustatius and Saba. Therefore, a cross-sectional population-based serosurveillance study was performed in this (recently girls-only HPV-vaccinated) population in 2017. METHODS Blood samples from participants (n = 1,823, 0-90 years) were tested for seven high-risk (hr)-HPV-specific IgG-antibodies using a VLP-based multiplex-immunoassay. Risk factors for HPV-seropositivity were analysed among persons unvaccinated aged ≥ 15 years who ever had sex (n = 1,080). RESULTS Among unvaccinated individuals aged ≥ 15 years, overall seropositivity was high (34%), with over half of them being seropositive for ≥ 2 hr-HPV types, and HPV16 and 52 being most prevalent (13%). Seroprevalence was substantial higher in unvaccinated women (51%) than men (18%), predominantly peaking in women aged 20-59 years, and was highest on St. Eustatius (38%). Besides age and sex, sexual risk factors were associated with HPV-seropositivity. CONCLUSIONS In accordance with the Caribbean region, seroprevalence of multiple hr-HPV types was high in CN. These data corroborate the decision regarding introduction of a sex-neutral HPV-vaccination program and the relevance for considering a population-based cervical cancer screening program.
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Affiliation(s)
- Regnerus A Vos
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
| | - Hella Pasmans
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Liza Tymchenko
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Alcira V A Janga-Jansen
- Department of Public Health, Public Entity Bonaire, Kaya Neerlandia 41, Kralendijk, Bonaire, Caribbean Netherlands, The Netherlands
| | - Sharda Baboe-Kalpoe
- Department of Public Health, Public Entity St. Eustatius, Cottageroad z/n, Oranjestad, St. Eustatius, Caribbean Netherlands, The Netherlands
| | - Koen Hulshof
- Department of Public Health, Public Entity Saba, The Bottom, Saba, Caribbean Netherlands, The Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Fiona R M van der Klis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Richards SD, Stonbraker S, Halpern M, Amesty S. Cervical cancer screening among transactional female sex workers in the Dominican Republic. Int J STD AIDS 2018; 29:1204-1214. [PMID: 29966506 PMCID: PMC6089663 DOI: 10.1177/0956462418779662] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cervical cancer is the third leading cause of cancer-related death and the second most diagnosed cancer among women in developing countries. We determined the prevalence of abnormal Papanicolaou (Pap), high-risk HPV (hrHPV), and colposcopy among transactional female sex workers (FSWs) in La Romana, Dominican Republic. The results of 144 FSWs of ages 18-54 years who completed a demographic interview and Pap testing with hrHPV detection between June 2015 and April 2016 were analyzed. Women with abnormal results were referred for colposcopy. Risk factors for abnormal Pap were assessed through bivariate and multivariate analyses. Overall, 36.1% (52/144) of Paps were abnormal and 43.4% (62/143) had hrHPV. Of all women with hrHPV and/or abnormal Pap (68/144; 47.2%), 61 (89.7%) were referred and 16 (26.2) underwent colposcopy. HPV16 and/or 18/45 was detected in 33.3% (15/45) of low-grade Paps. Binge drinking, weekly (AOR 5.1, 95% CI: 1.8-14.5) or daily (AOR 4.9, 95% CI: 1.5-16.6), and age at first sexual relation (AOR 1.2, 95% CI: 1.0-1.5) were significantly associated ( p < 0.05) with abnormal Pap. Although almost half of participants had abnormal Pap or hrHPV, few underwent colposcopy. Improving access to cervical cancer screening and follow-up for FSWs is imperative.
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Affiliation(s)
- Sheyla D Richards
- 1 Program for Global and Population Health, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Samantha Stonbraker
- 2 Columbia University School of Nursing, New York, NY, USA
- 3 Clínica de Familia, La Romana, Dominican Republic
| | - Mina Halpern
- 3 Clínica de Familia, La Romana, Dominican Republic
| | - Silvia Amesty
- 1 Program for Global and Population Health, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- 4 Heilbrunn Department of Population and Family Health, Columbia University, Mailman School of Public Health, New York, NY, USA
- 5 Center for Family and Community Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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Ward JM, Schmalenberg K, Antonishyn NA, Hambleton IR, Blackman EL, Levett PN, Gittens-St.Hilaire MV. Human papillomavirus genotype distribution in cervical samples among vaccine naïve Barbados women. Cancer Causes Control 2017; 28:1323-1332. [DOI: 10.1007/s10552-017-0959-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 09/08/2017] [Indexed: 11/27/2022]
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Ginindza TG, Stefan CD, Tsoka-Gwegweni JM, Dlamini X, Jolly PE, Weiderpass E, Broutet N, Sartorius B. Prevalence and risk factors associated with sexually transmitted infections (STIs) among women of reproductive age in Swaziland. Infect Agent Cancer 2017; 12:29. [PMID: 28559923 PMCID: PMC5445272 DOI: 10.1186/s13027-017-0140-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/16/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) remain an important public health problem with approximately half a billion new cases annually among persons aged 15-49 years. Epidemiological data on STIs among women of reproductive age in Swaziland are limited. The availability of epidemiological data on STIs and associated risk factors in this population is essential for the development of successful prevention, diagnosis and management strategies in the country. The study aimed to determine the prevalence and risk factors associated with STIs. METHODS A total of 655 women aged 15-49 years were systematically enrolled from five health facilities using a cross-sectional study design. Cervical specimen were tested using GeneXpert CT/NG Assays for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), GeneXpertTV Assay for Trichomonas vaginalis (TV), and GeneXpert HPV Assays for hr-HPV. Blood samples were tested using Alere Determine HIV-1/2Ag/Ab Combo and Trinity Biotech Uni-Gold Recombigen HIV test for confirmation for HIV, and Rapid Plasma Reagin and TPHA test for confirmation for Treponema pallidum (syphilis). Genital warts were assessed prior to specimen collection. Survey weighted analyses were done to estimate the population burden of STIs. RESULTS The four most common curable STIs: CT, NG, TV, Treponema pallidum (syphilis), as well as genital warts were considered in this study. The overall weighted prevalence of any of these five STIs was 19.4% (95% CI: 14.9-24.8), corresponding to 72 990 women with STIs in Swaziland. The estimated prevalences were 7.0% (95% CI: 4.1-11.2) for CT, 6.0% (95% CI: 3.8-8.8) for NG, 8.4% (95% CI: 5.4-12.8) for TV, 1.4% (95% CI: 1.1-10.2) for syphilis and 2.0% (95% CI: 1.0-11.4) for genital warts. The overall weighted HIV prevalence was 42.7% (95%CI: 35.7-46.2). Among hr-HPV positive women, 18.8% (95% CI: 13.1-26.3) had one STI, while 6.3% (95% CI: 3.3-11.7) had multiple STIs. Risk factors associated with STIs were being employed (OR = 2.2, 95% CI: 1.0-4.7), self-employed (OR = 2.8, 95% CI: 1.5-5.5) and being hr-HPV positive (OR = 2.0, 95% CI: 1.3-3.1). Age (0.9, 95% CI: 0.8-0.9), being married (OR = 0.4, 95% CI: 0.3-0.7) and not using condoms with regular partners (OR = 0.5, 95% CI: 0.3-0.9) were inversely associated with STIs. CONCLUSION STIs are highly prevalent among women of reproductive age in Swaziland. Thus, a comprehensive STIs screening, surveillance and treatment programme would be justified and could potentially lower the burden of STIs in the country.
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Affiliation(s)
- Themba G. Ginindza
- Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Mazisi Kunene Road, 4041 Durban, South Africa
| | | | - Joyce M. Tsoka-Gwegweni
- Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Mazisi Kunene Road, 4041 Durban, South Africa
| | - Xolisile Dlamini
- Epidemiology Unit, Ministry of Health and Social Welfare, Mbabane, Swaziland
| | - Pauline E. Jolly
- Department of Epidemiology, University of Alabama, Birmingham, USA
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Nathalie Broutet
- World Health Organization; Department of Reproductive Health and Research, Geneva, Switzerland
| | - Benn Sartorius
- Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Mazisi Kunene Road, 4041 Durban, South Africa
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Andall-Brereton G, Brown E, Slater S, Holder Y, Luciani S, Lewis M, Irons B. Prevalence of high-risk human papillomavirus among women in two English-speaking Caribbean countries. Rev Panam Salud Publica 2017. [PMID: 28614466 PMCID: PMC6660866 DOI: 10.26633/rpsp.2017.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To characterize high-risk human papillomavirus (HPV) infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. METHODS Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1) a specimen for a Papanicolaou (Pap) test and (2) a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace). High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. RESULTS High-risk HPV was detected in 102 of 404 (25.2%) in Saint Kitts and Nevis and in 109 of 368 (29.6%) in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies) and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. CONCLUSIONS These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study's results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.
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Affiliation(s)
- Glennis Andall-Brereton
- Caribbean Public Health AgencyCaribbean Public Health AgencyPort-of-SpainTrinidad and TobagoCaribbean Public Health Agency, Port-of-Spain, Trinidad and Tobago.
| | - Eulynis Brown
- Ministry of HealthMinistry of HealthSaint Kitts and NevisMinistry of Health, Saint Kitts and Nevis, Basseterre, Saint Kitts and Nevis.
| | - Sherian Slater
- Ministry of Health, Wellness and the EnvironmentMinistry of Health, Wellness and the EnvironmentMinistry of Health, Wellness and the Environment, Saint Vincent and the Grenadines, Kingstown, Saint Vincent and the Grenadines.
| | - Yvette Holder
- Office of Eastern Caribbean CoordinationPan American Health Organization/World Health OrganizationBarbadosOffice of Eastern Caribbean Coordination, Pan American Health Organization/World Health Organization, Bridgetown, Barbados.,Send correspondence to Beryl Irons: ,
| | - Silvana Luciani
- Pan American Health OrganizationPan American Health OrganizationWashingtonUnited States of AmericaPan American Health Organization, Washington, D.C., United States of America.
| | - Merle Lewis
- Pan American Health OrganizationPan American Health OrganizationWashingtonUnited States of AmericaPan American Health Organization, Washington, D.C., United States of America.
| | - Beryl Irons
- Office of Eastern Caribbean CoordinationPan American Health Organization/World Health OrganizationBarbadosOffice of Eastern Caribbean Coordination, Pan American Health Organization/World Health Organization, Bridgetown, Barbados.
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Mijit F, Ablimit T, Abduxkur G, Abliz G. Distribution of human papillomavirus (HPV) genotypes detected by routine pap smear in Uyghur-Muslim women from Karasay Township Hotan (Xinjiang, China). J Med Virol 2015; 87:1960-5. [PMID: 26081269 PMCID: PMC5033003 DOI: 10.1002/jmv.24240] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2015] [Indexed: 11/12/2022]
Abstract
HPV infection is an important public health problem in developing countries. We investigated HPV genotypes in the Uyghur female population of Karasay Township, Hotan region. A population-based cervical cancer screening was conducted for 4,500 women in Karasay Township, Xinjiang Hotan, China. A total of 900 women were selected by systematic sampling with a 5:1 proportion (ages 20-69). The subjects completed a questionnaire and consented to HPV typing and Pap smear examination. Colposcopic biopsies were performed for patients with cytological abnormalities (≥ ASCUS). A total of 117 of the 900 women (13%) assessed were infected with HPV. The most common subtype was HPV-16, and other common high-risk types included HPV-58 and HPV-39. A total of 40 women (4.44%) were identified with abnormal cytology (≥ ASCUS) by Pap smear. A significant link was found between HPV prevalence and cytological diagnosis. The HPV infection rates for the patients with cervical inflammation, CIN, and cancer were 18.18%, 64.71%, and 100%, respectively. Significant differences in HPV infection rates were found among the patients with the three groups of pathological results. In Karasay, the HPV infection rate in Uyghur women is lower than previously reported; however, the proportion infected with HR-HPV is higher. HPV-16, HPV-58, and HPV-39 are the most prevalent genotypes.
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Affiliation(s)
- Fatima Mijit
- 5th Department of the Gynecological SurgeryXinjiang Medical University Affiliated Tumor HospitalPeople's Republic of China
| | - Tangnur Ablimit
- 5th Department of the Gynecological SurgeryXinjiang Medical University Affiliated Tumor HospitalPeople's Republic of China
| | - Guzalnur Abduxkur
- 5th Department of the Gynecological SurgeryXinjiang Medical University Affiliated Tumor HospitalPeople's Republic of China
| | - Guzalnur Abliz
- 5th Department of the Gynecological SurgeryXinjiang Medical University Affiliated Tumor HospitalPeople's Republic of China
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Cordel N, Ragin C, Trival M, Tressières B, Janky E. High-risk human papillomavirus cervical infections among healthy women in Guadeloupe. Int J Infect Dis 2015; 41:13-6. [PMID: 26597118 PMCID: PMC4743658 DOI: 10.1016/j.ijid.2015.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 10/12/2015] [Accepted: 10/16/2015] [Indexed: 12/19/2022] Open
Abstract
Objective To assess high-risk human papillomavirus (HR HPV) cervical infections and their type distribution among healthy women in Guadeloupe, French West Indies. Methods The details of consecutive non-pregnant women who attended cervical cancer screening and had HPV genotyping performed at the largest pathology laboratory on the island from January 1, 2013 to December 31, 2014 were recorded retrospectively. All women with available HPV genotyping results were included in the study. Results HR HPV genotyping results for 618 women (median age 42 years) were collected. The overall prevalence rate of HR HPV cervical infection was 36.1% (95% confidence interval (CI) 32.3–40.0%), with the following type distribution: HPV 16 or 18 irrespective of other HPV types, 7.3% (95% CI 5.4–9.6%); other HR HPV types excluding HPV 16 or 18, 28.8% (95% CI 25.3–32.5%). The prevalence rates of overall HR HPV and HR HPV other than 16 or 18 infection increased significantly (p < 0.001) with the severity of cytology grade, from 19.7% for normal cytology to 53.8% in atypical squamous cells of undetermined significance (ASC-US) and 67.7% in low-grade squamous intraepithelial lesions (LSIL). Conclusion The high prevalence rate of HR HPV cervical infection with genotypes other than 16 and 18 in Guadeloupe, irrespective of age and the cytology grade, suggests a potential benefit of the new nine-valent HPV vaccine to prevent HPV infection-related cancers in this Caribbean country.
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Affiliation(s)
- Nadège Cordel
- Dermatology and Internal Medicine Unit, Guadeloupe University Hospital and EA 4546, CELTEC, Antilles University, BP 465, 97159 Pointe-à-Pitre cedex, Guadeloupe.
| | - Camille Ragin
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Temple Health and Department of Epidemiology and Biostatistics, Temple University, College of Public Health, Philadelphia, Pennsylvania, USA
| | | | - Benoît Tressières
- Centre d'Investigation Clinique Antilles-Guyane, Guadeloupe, Inserm CIC 1424
| | - Eustase Janky
- Parent-Child Department, Gynecology and Obstetrics Unit, Guadeloupe University Hospital, EA 4546, CELTEC, Antilles University, Guadeloupe
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Banister CE, Messersmith AR, Cai B, Spiryda LB, Glover SH, Pirisi L, Creek KE. Disparity in the persistence of high-risk human papillomavirus genotypes between African American and European American women of college age. J Infect Dis 2014; 211:100-8. [PMID: 25028692 DOI: 10.1093/infdis/jiu394] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cervical cancer incidence and mortality rates are higher in African Americans than in European Americans (white, non-Hispanic of European ancestry). The reasons for this disparity are not known. METHODS We recruited a population-based longitudinal cohort of 326 European American and 113 African American female college freshmen in Columbia, South Carolina, to compare clearance of high-risk human papillomavirus (HR-HPV) infection between ethnicities. HPV testing and typing from samples obtained for Papanicolaou testing occurred every 6 months. RESULTS African American participants had an increased risk of testing positive for HR-HPV, compared with European American participants, but the frequency of incident HPV infection was the same in African American and European American women. Thus, exposure to HPV could not explain the higher rate of HPV positivity among African American women. The time required for 50% of participants to clear HR-HPV infection was 601 days for African American women (n = 63) and 316 days for European American women (n = 178; odds ratio [OR], 1.61; 95% confidence interval [CI], 1.08-2.53). African American women were more likely than European American women to have an abnormal result of a Papanicolaou test (OR, 1.58; 95% CI, 1.05-2.39). CONCLUSIONS We propose that the longer time to clearance of HR-HPV among African American women leads to increased rates of abnormal results of Papanicolaou tests and contributes to the increased rates of cervical cancer observed in African American women.
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Affiliation(s)
- Carolyn E Banister
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy
| | - Amy R Messersmith
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy
| | - Bo Cai
- Department of Epidemiology and Biostatistics
| | | | - Saundra H Glover
- Department of Health Services Policy and Management Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health
| | - Lucia Pirisi
- Department of Pathology, Microbiology and Immunology, School of Medicine, University of South Carolina, Columbia
| | - Kim E Creek
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy
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Geraets DT, Grünberg AW, van der Helm JJ, Schim van der Loeff MF, Quint KD, Sabajo LOA, de Vries HJC. Cross-sectional study of genital carcinogenic HPV infections in Paramaribo, Suriname: prevalence and determinants in an ethnically diverse population of women in a pre-vaccination era. Sex Transm Infect 2014; 90:627-33. [DOI: 10.1136/sextrans-2013-051384] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Reams RR, Odedina FT, Pressey S. Advocacy resource: engaging the media and promoting your cancer program in Africa. Infect Agent Cancer 2013; 8 Suppl 1:S5. [PMID: 23902643 PMCID: PMC3716690 DOI: 10.1186/1750-9378-8-s1-s5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
To address the need for a significant increase in cancer advocacy programs in Africa, the University of Florida (UF), the Prostate Net, and the African Organization for Research and Training in Cancer (AORTIC) co-hosted the first biennial International Workshop on Cancer Advocacy for African Countries (CAAC) on November 29, 2011, one-day prior to AORTIC's 8th International Cancer Conference in Cairo, Egypt. Over 70 African cancer advocates representing about 12 African countries participated in this workshop.The primary goal of the one-day workshop was to inform, educate and empower African cancer advocates to increase the promotion of their cancer programs. The first half of the workshop consisted of five formal PowerPoint presentations focused on the following topics: (a) Understanding Your Community and Assessing your Community Health Assets and Needs; (b) Developing a successful advocacy model for your cancer program; (c) Developing a Relationship with your Elected Officials to Advocate Cancer-related Policies; (d) Engaging the Media and promoting your cancer program; and (e) Developing advocacy plans for sustainability. In this article we summarize the informational content given in the PowerPoint presentation entitled "Engaging the Media and promoting your cancer program". The content given in this article is useful as a how-to guide for both the beginner and the experienced cancer advocate who wants to establish/promote a cancer awareness program.
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Affiliation(s)
- R Renee Reams
- College of Pharmacy & Pharmaceutical Sciences, Florida A&M University, Tallahassee, Florida 32307, USA
| | - Folakemi T Odedina
- College of Pharmacy, University of Florida, Gainesville, Florida, 33772, USA
| | - Shannon Pressey
- College of Pharmacy, University of Florida, Gainesville, Florida, 33772, USA
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Cordel N, Tressières B, Bonnecarrere L. Squamous cell carcinomas in Afro-Caribbean women. J Am Acad Dermatol 2012; 67:788-9. [PMID: 22980249 DOI: 10.1016/j.jaad.2011.09.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 09/16/2011] [Accepted: 09/24/2011] [Indexed: 11/24/2022]
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Prevalence and risk factors of HPV infection among women from various provinces of the world. Arch Gynecol Obstet 2011; 285:771-7. [DOI: 10.1007/s00404-011-2155-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2010] [Accepted: 11/23/2011] [Indexed: 10/14/2022]
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Oral HPV infection and sexuality: a cross-sectional study in women. Int J Mol Sci 2011; 12:3928-40. [PMID: 21747715 PMCID: PMC3131599 DOI: 10.3390/ijms12063928] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 04/12/2011] [Accepted: 06/03/2011] [Indexed: 01/22/2023] Open
Abstract
Human Papillomavirus (HPV) is the main risk factor for cervical cancers and is associated with close to 36% of oropharyngeal cancers. There is increasing evidence that oral HPV transmission is related to sexual behavior but to our knowledge studies that involve women who have sex with women have not been performed. We examined the prevalence of oral HPV according to sexual behavior among a population-based sample of 118 women and have made some inferences of possible predictors of oral HPV infection. Women were categorized as heterosexual (history of vaginal sex and/or oral sex with males only, n = 75), bisexual (history of vaginal sex and oral sex with females, n = 32) and other (no history of vaginal sex but oral sex with females [homosexuals], virgins and women with incomplete sexual exposure data, n = 11) The prevalence of oral HPV infection was 12/118 (10.2%) for the overall study population and was not significantly different between heterosexual and bisexual women (10.7% (8/75) vs. 12.5% (4/32), p = 0.784). There was no oral HPV detected among homosexual women, virgins or among women where sexual exposure was unknown. Never smokers were more likely to be oral HPV+ compared to former smokers (Adjusted Odds Ratio (Adj OR) = 0.1, 95% CI, 0.0–1.1) and there was no difference in risk between never smokers and current smokers (Adj OR = 0.7, 95% CI, 0.1–4.6). Twenty-five percent (3/12) of oral HPV+ women had a history of HPV and/or genital warts compared to 9% (10/106) of oral HPV-women (p = 0.104). For the women with a history of vaginal sex (n = 110), oral HPV status was statistically significantly different according to oral sex exposure (p = 0.039). A higher proportion of oral HPV-positive women reported that they had no history of oral sex exposure compared to oral HPV-negative women (4/12, 33% vs. 7/98, 8%). The prevalence of cervical HPV infection did not vary between heterosexuals and bisexuals (35.7% (25/70) vs. 35.5% (11/31), p-value 0.411) and for all other women the cervical HPV prevalence was significantly lower (11.1%, 1/9). Our study suggests that smoking and sexual behavior involving males rather than female partners may be possible predictors of oral HPV infection in women. Further studies with larger sample size are needed to confirm these findings.
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Distribution patterns of infection with multiple types of human papillomaviruses and their association with risk factors. PLoS One 2011; 6:e14705. [PMID: 21379574 PMCID: PMC3040737 DOI: 10.1371/journal.pone.0014705] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Accepted: 01/28/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Infection with multiple types of human papillomavirus (HPV) is one of the main risk factors associated with the development of cervical lesions. In this study, cervical samples collected from 1,810 women with diverse sociocultural backgrounds, who attended to their cervical screening program in different geographical regions of Colombia, were examined for the presence of cervical lesions and HPV by Papanicolau testing and DNA PCR detection, respectively. PRINCIPAL FINDINGS The negative binomial distribution model used in this study showed differences between the observed and expected values within some risk factor categories analyzed. Particularly in the case of single infection and coinfection with more than 4 HPV types, observed frequencies were smaller than expected, while the number of women infected with 2 to 4 viral types were higher than expected. Data analysis according to a negative binomial regression showed an increase in the risk of acquiring more HPV types in women who were of indigenous ethnicity (+37.8%), while this risk decreased in women who had given birth more than 4 times (-31.1%), or were of mestizo (-24.6%) or black (-40.9%) ethnicity. CONCLUSIONS According to a theoretical probability distribution, the observed number of women having either a single infection or more than 4 viral types was smaller than expected, while for those infected with 2-4 HPV types it was larger than expected. Taking into account that this study showed a higher HPV coinfection rate in the indigenous ethnicity, the role of underlying factors should be assessed in detail in future studies.
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Ripabelli G, Grasso GM, Del Riccio I, Tamburro M, Sammarco ML. Prevalence and genotype identification of human papillomavirus in women undergoing voluntary cervical cancer screening in Molise, central Italy. Cancer Epidemiol 2010; 34:162-7. [PMID: 20080070 DOI: 10.1016/j.canep.2009.12.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 11/24/2009] [Accepted: 12/09/2009] [Indexed: 12/20/2022]
Abstract
We examined the prevalence of HR- and LR-HPV by Linear Array genotyping test in 299 women aged 18-63 years who consecutively visited Molise Region main hospitals for routine Pap smear between February and August 2008. Ninety women were positive for any HPV (30.1%), and 66 for any HR-HPV (22.1%). The most prevalent HR-HPV types were HPV 16 (22.2% of all women with HPV infection), HPV 53 (14.4%), and HPV 66 (14.4%). HPV infections increased from 15.8% in the 18-20 years group to 50.0% in the 21-23 years group and then decreased to 9.1% in those aged 50 years or more (p=0.008). Multiple HPV infections were observed in 15.7% of the study sample (52.2% of all HPV positive). There is a significantly higher prevalence of multiple infections in 18-32 years group women (24.5%) compared with females aged 33 years or more (6.8%) (p<0.005). Current smokers were at increased risk of HPV infection (44.2% of HPV infections compared with 23.5% in never smokers, and 25.3% of multiple HPV infections compared with 11.3%; p=0.001). HR-HPV infections were higher in women never been pregnant (27.1% compared with 7.7%; p=0.001). Oral contraceptive use was completely unrelated to infection. Among the 122 women who had both cytological examination and HPV results, multiple HR-HPV types were found in 36.8% of those with abnormal cervical findings, and in 13.6% of those with normal cervical findings (p=0.05). The results of the present investigation provide further evidence for the notion that cervical HPV infection is more widespread than previously suggested.
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Affiliation(s)
- Giancarlo Ripabelli
- Department of Health Science, School of Medicine, University of Molise, via De Sanctis, 86100 Campobasso, Italy
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Chumworathayi B, Thinkhamrop J, Blumenthal PD, Thinkhamrop B, Pientong C, Ekalaksananan T. Cryotherapy for HPV clearance in women with biopsy-confirmed cervical low-grade squamous intraepithelial lesions. Int J Gynaecol Obstet 2009; 108:119-22. [PMID: 19892345 DOI: 10.1016/j.ijgo.2009.09.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 08/18/2009] [Accepted: 09/29/2009] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the clearance rate of HPV infection among women aged older than 30 years with biopsy-confirmed cervical low-grade squamous intraepithelial lesions (LSIL) 1 year after cryotherapy with the spontaneous clearance rate (observation). METHOD HPV DNA typing by polymerase chain reaction and reverse line blot hybridization were used to identify 14 high-risk types and 23 low-risk types. HPV DNA sequencing was also used for other types. RESULT Between December 2007 and March 2009, 100 women were recruited to the study and 60 cases had positive results on HPV testing. Twenty-nine patients were randomly allocated to the cryotherapy group and 31 to the observation group. At 1 year, 89.7% (26/29; 95% CI, 78.6-100%) of the cryotherapy group and 90.3% (28/31; 95% CI, 79.9-100%) of the observation group had negative results on HPV testing (0.6% difference; 95% CI, -15.8 to 14.6%, P=0.94). CONCLUSION Cryotherapy failed to increase the clearance of prevalent HPV infections among women with LSIL, although in both arms the clearance rates were above 80%. However, in coupling with visual inspection with acetic acid as a single visit approach, its effect on prevention of HSIL and cervical cancer is still promising. Therefore, cryotherapy should not be withdrawn from such programs.
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Ragin C, Taioli E. The Second International African-Caribbean Cancer Consortium for the study of viral, genetic and environmental cancer risk factors. Infect Agent Cancer 2009; 4 Suppl 1:S1. [PMID: 19208200 PMCID: PMC2638454 DOI: 10.1186/1750-9378-4-s1-s1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Camille Ragin
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA, USA
- The University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
- Department of Epidemiology and Biostatistics, Downstate School of Public Health, State University of New York, USA
| | - Emanuela Taioli
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA, USA
- The University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
- Department of Epidemiology and Biostatistics, Downstate School of Public Health, State University of New York, USA
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