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Altová A, Kulhánová I, Reisser K, Netrdová P, Brož J, Eikemo TA, Balaj M, Lustigová M. Educational inequalities in cervical cancer screening participation in 24 European countries. Public Health 2024; 233:1-7. [PMID: 38805834 DOI: 10.1016/j.puhe.2024.04.036] [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: 01/23/2024] [Revised: 04/10/2024] [Accepted: 04/25/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVES Cervical cancer screening (CCS) is an important public health measure for early detection of cervical cancer and prevents a large proportion of cervical cancer deaths. However, participation in CCS is relatively low and varies substantially by country and socio-economic position. This study aimed to provide up-to-date participation rates and estimates on educational inequalities in CCS participation in 24 European countries with population-based CCS programmes. STUDY DESIGN This was a cross-sectional study. METHODS Using data from the European Health Interview Survey (EHIS) conducted in 2019, 80,479 women aged 25-64 years were included in the analyses. First, standardized participation rates and standardized participation rates by educational attainment were calculated for all 24 countries based on each country-specific screening programme organization. Second, a series of generalized logistic models was applied to assess the effect of education on CCS participation. RESULTS Screening participation rates ranged from 34.1% among low-educated women in Romania to 97.1% among high-educated women in Finland. We observed that lower-educated women were less likely to attend CCS than their higher-educated counterparts. Largest educational gaps were found in Sweden (odds ratio [OR] = 6.36, 95% confidence interval [CI] = 3.89-10.35) and Poland (odds ratio = 5.80, 95% CI = 4.34-7.75). CONCLUSION Population-based screening initiatives have successfully reduced participation differences between women with medium and high educational attainment in some countries; however, persistent disparities still exist between women with low and high levels of education. There is an urgent need to increase participation rates of CCS, especially among lower-educated women.
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Affiliation(s)
- A Altová
- Department of Demography and Geodemography, Faculty of Science, Charles University, Albertov 6, Praha 2, 12800, Czech Republic.
| | - I Kulhánová
- Department of Demography and Geodemography, Faculty of Science, Charles University, Albertov 6, Praha 2, 12800, Czech Republic; Department of Social Geography and Regional Development, Faculty of Science, Charles University, Albertov 6, Praha 2, 12800, Czech Republic
| | - K Reisser
- Faculty of Medicine, Leipzig University, Liebigstraße, 04103, Leipzig, Germany; Faculty of Health, Medicine, and Life Sciences, Maastricht University, Minderbroedersberg 4-6, 6211 LK Maastricht, the Netherlands
| | - P Netrdová
- Department of Social Geography and Regional Development, Faculty of Science, Charles University, Albertov 6, Praha 2, 12800, Czech Republic
| | - J Brož
- Department of Internal Medicine, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5, 150 06, Czech Republic
| | - T A Eikemo
- Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology, Edvard Bulls veg 17049 Trondheim, Norway
| | - M Balaj
- Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology, Edvard Bulls veg 17049 Trondheim, Norway
| | - M Lustigová
- Department of Social Geography and Regional Development, Faculty of Science, Charles University, Albertov 6, Praha 2, 12800, Czech Republic; National Institute of Public Health, Šrobárova 49/48, Praha 10, 100 00, Czech Republic
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Pešut E, Šimić I, Fureš R, Milutin Gašperov N, Lež C, Feratović F, Kukina Žvigač T, Grce M, Erceg Ivkošić I, Sabol I. Monitoring HPV Prevalence and Risk Cofactors for Abnormal Cytology in the Post-Vaccination Period among Croatian Women. Viruses 2024; 16:642. [PMID: 38675981 PMCID: PMC11054414 DOI: 10.3390/v16040642] [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: 03/07/2024] [Revised: 04/12/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
The incidence and mortality rate of cervical cancer in Croatia remains a health challenge despite screening efforts. Besides the persistent infection with HPV, the development of cancer is also associated with some cofactors. The goal of this study was to assess circulating HPV genotypes and risk factors for the development of cervical precancer after almost 16 years from the onset of HPV vaccination in Croatia. In this study, a total of 321 women attending gynecological care were evaluated. Relevant medical and demographic information, including cytology, were collected. HPV genotyping was performed by PCR. Comparing the HPV types found in circulation in the pre-vaccination (1999-2015) and post-vaccination periods (2020-2023), a statistically significant reduction in HPV 31 was noted, while the overall prevalence increased in the post-vaccination period. Besides the expected HPV positivity as a risk factor, the history of smoking was associated with LSIL or worse cytology at enrollment. For the first time, this population study revealed a statistically significant shift in the HPV genotype in the post-vaccination period, as well as the confirmation of risk factors for the development of abnormal cytology among Croatian women.
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Affiliation(s)
- Ena Pešut
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička Cesta 54, 10000 Zagreb, Croatia; (E.P.); (I.Š.); (N.M.G.); (M.G.)
| | - Ivana Šimić
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička Cesta 54, 10000 Zagreb, Croatia; (E.P.); (I.Š.); (N.M.G.); (M.G.)
| | - Rajko Fureš
- General Hospital Zabok, Bračak 8, 49210 Zabok, Croatia; (R.F.); (C.L.); (F.F.); (T.K.Ž.)
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University Osijek, Crkvena 21, 31000 Osijek, Croatia
- Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 5, 51000 Rijeka, Croatia
| | - Nina Milutin Gašperov
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička Cesta 54, 10000 Zagreb, Croatia; (E.P.); (I.Š.); (N.M.G.); (M.G.)
| | - Cvjetko Lež
- General Hospital Zabok, Bračak 8, 49210 Zabok, Croatia; (R.F.); (C.L.); (F.F.); (T.K.Ž.)
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University Osijek, Crkvena 21, 31000 Osijek, Croatia
| | - Fabijan Feratović
- General Hospital Zabok, Bračak 8, 49210 Zabok, Croatia; (R.F.); (C.L.); (F.F.); (T.K.Ž.)
| | - Tomica Kukina Žvigač
- General Hospital Zabok, Bračak 8, 49210 Zabok, Croatia; (R.F.); (C.L.); (F.F.); (T.K.Ž.)
| | - Magdalena Grce
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička Cesta 54, 10000 Zagreb, Croatia; (E.P.); (I.Š.); (N.M.G.); (M.G.)
| | - Ivana Erceg Ivkošić
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University Osijek, Crkvena 21, 31000 Osijek, Croatia
- Special Hospital Sveta Katarina, Branimirova 71 E, 10000 Zagreb, Croatia
| | - Ivan Sabol
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička Cesta 54, 10000 Zagreb, Croatia; (E.P.); (I.Š.); (N.M.G.); (M.G.)
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E6/E7 mRNA Expression of the Most Prevalent High-Risk HPV Genotypes in Cervical Samples from Serbian Women. Diagnostics (Basel) 2023; 13:diagnostics13050917. [PMID: 36900061 PMCID: PMC10000477 DOI: 10.3390/diagnostics13050917] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023] Open
Abstract
Cervical cancer caused by persistent infection with HR HPV genotypes is the second leading cause of death in women aged 15 to 44 in Serbia. The expression of the E6 and E7 HPV oncogenes is considered as a promising biomarker in diagnosing high-grade squamous intraepithelial lesions (HSIL). This study aimed to evaluate HPV mRNA and DNA tests, compare the results according to the severity of the lesions, and assess the predictive potential for the diagnosis of HSIL. Cervical specimens were obtained at the Department of Gynecology, Community Health Centre Novi Sad, Serbia, and the Oncology Institute of Vojvodina, Serbia, during 2017-2021. The 365 samples were collected using the ThinPrep Pap test. The cytology slides were evaluated according to the Bethesda 2014 System. Using a real-time PCR test, HPV DNA was detected and genotyped, while the RT-PCR proved the presence of E6 and E7 mRNA. The most common genotypes in Serbian women are HPV 16, 31, 33, and 51. Oncogenic activity was demonstrated in 67% of HPV-positive women. A comparison of the HPV DNA and mRNA tests to assess the progression of cervical intraepithelial lesions indicated that higher specificity (89.1%) and positive predictive value (69.8-78.7%) were expressed by the E6/E7 mRNA test, while higher sensitivity was recorded when using the HPV DNA test (67.6-88%). The results determine the higher probability of detecting HPV infection by 7% provided by the mRNA test. The detected E6/E7 mRNA HR HPVs have a predictive potential in assessing the diagnosis of HSIL. The oncogenic activity of HPV 16 and age were the risk factors with the strongest predictive values for the development of HSIL.
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Kaliterna V, Kaliterna P, Pejkovic L, Vulic R, Zanchi L, Cerskov K. Prevalence of Human Papillomavirus (HPV) among Females in the General Population of the Split and Dalmatia County and Its Association with Genital Microbiota and Infections: A Prospective Study. Viruses 2023; 15:443. [PMID: 36851657 PMCID: PMC9964398 DOI: 10.3390/v15020443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/09/2023] Open
Abstract
We conducted a prospective study with the aim of determining HPV prevalence and type distribution in the general female population of Southern Croatia (SDC), and to detect the presence of other microorganisms in the lower part of the female reproductive system and their possible influence on the frequency of HPV infection. Data were collected during routine check-up exams. All participants were examined by a gynecologist, and cervico-vaginal scrapings/swabs were collected, for cytological (Pap smear) and microbiological (for bacterial growth, genital mycoplasmas, chlamydia, and HPV) analysis. Informed consent was obtained from all participants with accompanying questionnaire. A total of 1050 asymptomatic women living in SDC participated in the study during a one-year period, and 107 of them (10.2%) had HR-HPV infection. We found that the presence of some bacteria (Ureaplasma, Chlamydia, and Gardnerella) in the lower part of the female genital system has a positive correlation with the frequency of HPV infection and, consequently, a possible influence on faster progression to cervical dysplasia caused by HPV. We consider that inclusion of screening for sexually transmitted infections as monitoring in women with HPV infection could help to find women at risk of cervical cancer progression.
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Affiliation(s)
- Vanja Kaliterna
- Teaching Institute for Public Health of Split and Dalmatia County, 21000 Split, Croatia
- University Department of Health Studies, University of Split, 21000 Split, Croatia
| | - Petar Kaliterna
- School of Medicine, University of Split, 21000 Split, Croatia
| | | | | | - Linda Zanchi
- Gynecological Practice, 21212 Kastel Sucurac, Croatia
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Gavrankapetanovic F, Sljivo A, Dadic I, Mehmedbasic N. Epidemiological Aspects of Age and Genotypical Occurrence of HPV Infection Among Females of Canton Sarajevo Over a 10-year Period. Mater Sociomed 2022; 34:260-263. [PMID: 36936897 PMCID: PMC10019866 DOI: 10.5455/msm.2022.34.260-263] [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: 09/12/2022] [Accepted: 10/24/2022] [Indexed: 03/21/2023] Open
Abstract
Background Human papillomaviruses (HPV) are one of the most prevalent causes of cervical, anal, and oral cancer, and it is believed that nearly all sexually active males and females have been infected with HPV at some point in their lives. Objective The purpose of this study is to highlight epidemiological characteristics of the age and genotypical incidence of HPV infection among females in Canton Sarajevo during a 10-year period. Methods This cross-sectional study was conducted in the period between January 2012 and December 2021 at the medical institutions "Zavod za Ginekologiju, Perinatologiju i Neplodnost "Mehmedbašić" among females who were admitted for a routine gynaecological exam in Canton Sarajevo in Bosnia and Herzegovina. Results In total, 1517 patients who reported typical sexarche at 18.35±1.92, having one 721 (47.5%) sexual partner, regular use of contraceptive methods 820 (54.5%) with male condom 513 (62.6%) being the dominant choice of contraception and having gynacological hereditary oncological positive history 141 (9.3%), were included in the study from which 653 (43.05%) patients had positive HPV test and 864 (56.95%) had negative HPV results. HPV positive patients, 386 (59.1%) were infected either with one type of virus only, while 267 (40.9%) patients were infected with multiple virus strains where we have identified 166 virus strain combinations. Analysis showed that the patients infected by only one virus strain were one of next specific HPV viruses: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68. HPV-16 was the predominately strain 16 (22.5%) identified among all the patients. Mean age of HPV positive patients was 33.38±7.85, ranging from 18 to 61 years. Conclusion This study highlights the significance of the most frequent HPV high-risk strains (HPV-16, -18, -31.-33,-45,-52, and -58) among the Bosnia and Herzegovina population as one of the most common cancer-causing strains worldwide.
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Affiliation(s)
- Fatima Gavrankapetanovic
- Clinical Center of University of Sarajevo, University of Sarajevo, Sarajevo, Bosnia and Hercegovina
| | - Armin Sljivo
- Emergency Medicine Department of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Ilma Dadic
- Health Center of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Naida Mehmedbasic
- Center for Gynecology, Perinatology, Obstetrics and Fertility “Mehmedbasic”, Sarajevo, Bosnia and Herzegovina
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The Prevalence, Genotype Distribution and Risk Factors of Human Papillomavirus in Tunisia: A National-Based Study. Viruses 2022; 14:v14102175. [PMID: 36298732 PMCID: PMC9611589 DOI: 10.3390/v14102175] [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: 08/25/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 11/28/2022] Open
Abstract
There are limited national population-based studies on HPV genotypes distribution in Tunisia, thus making difficult an assessment of the burden of vaccine-preventable cervical cancer. In this context, we conducted a national survey to determine the HPV prevalence and genotypes distribution and the risk factors for HPV infections in Tunisian women. This is a cross-sectional study performed between December 2012 and December 2014. A liquid-based Pap smear sample was obtained from all women and samples' DNAs were extracted. Only women with betaglobin-positive PCR were further analysed for HPV detection and typing by a nested-PCR of the L1 region followed by next-generation sequencing. A multiple logistic regression model was used for the analysis of associations between the variables. A total of 1517 women were enrolled in this study, and 1229 out of the 1517 cervical samples were positive for the betaglobin control PCR and tested for HPV. Overall HPV infection prevalence was measured to be 7.8% (96/1229), with significant differences between the grand regions, ranging from 2% in the North to 13.1% in Grand Tunis. High-risk HPV genotypes accounted for 5% of the infections. The most prevalent genotypes were HPV 31 (1%), 16 (0.9%), 59 (0.7%). HPV18 was detected only in four cases of the study population. Potential risk factors were living in Grand Tunis region (OR: 7.94 [2.74-22.99]), married status (OR: 2.74 [1.23-6.13]), smoking habit (OR: 2.73 [1.35-5.51]), occupation (OR: 1.81 [1.09-3.01]) and women with multiple sexual partners (OR: 1.91 [1.07-3.39]). These findings underscore the need to evaluate the cost effectiveness of HPV vaccine implementation, contribute to the evidence on the burden of HPV infections, the critical role of sexual behaviour and socioeconomic status, and call for increased support to the preventive program of cervical cancer in Tunisia.
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Rebolj M, Mathews CS, Pesola F, Cuschieri K, Denton K, Kitchener H. Age-specific outcomes from the first round of HPV screening in unvaccinated women: Observational study from the English cervical screening pilot. BJOG 2022; 129:1278-1288. [PMID: 34913243 DOI: 10.1111/1471-0528.17058] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/28/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To report detailed age-specific outcomes from the first round of an English pilot studying the implementation of high-risk human papillomavirus (HR-HPV) testing in primary cervical screening. DESIGN Observational study with screening in 2013-2016, followed by two early recalls and/or colposcopy until the end of 2019. SETTING Six NHS laboratory sites. POPULATION A total of 1 341 584 women undergoing screening with HR-HPV testing or liquid-based cytology (LBC). METHODS Early recall tests and colposcopies were recommended, depending on the nature of the screening-detected abnormality. MAIN OUTCOME MEASURES We reported standard screening process indicators, e.g. proportions with an abnormality, including high-grade cervical intraepithelial neoplasia (CIN2+) or cancer, and the positive predictive value (PPV) of colposcopy for CIN2+, by screening test and age group. RESULTS Among unvaccinated women screened with HR-HPV testing at age 24-29 years, 26.9% had a positive test and 10.4% were directly referred to colposcopy following cytology triage, with a PPV for CIN2+ of 47%. At 50-64 years of age, these proportions were much lower: 5.3%, 1.2% and 27%, respectively. The proportions of women testing positive for HR-HPV without cytological abnormalities, whose early recall HR-HPV tests returned negative results, were similar across the age spans: 54% at 24-29 years and 55% at 50-64 years. Two-thirds of infections at any age were linked to non-16/18 genotypes. Among women with CIN2, CIN3 or cervical cancer, however, the proportion of non-16/18 infections increased with age. As expected, the detection of abnormalities was lower following screening with LBC. CONCLUSIONS These data provide a reliable reference for future epidemiological studies, including those concerning the effectiveness of HPV vaccination. TWEETABLE ABSTRACT Data from the English pilot study provide a comprehensive overview of abnormalities detected through HPV screening.
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Affiliation(s)
- Matejka Rebolj
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Christopher S Mathews
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Francesca Pesola
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Kate Cuschieri
- Scottish HPV Reference Laboratory, Royal Infirmary of Edinburgh, NHS Lothian Scotland, Edinburgh, UK
| | - Karin Denton
- Severn Pathology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Henry Kitchener
- Division of Cancer Sciences, University of Manchester, Manchester, UK
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Human Papillomaviruses-Associated Cancers: An Update of Current Knowledge. Viruses 2021; 13:v13112234. [PMID: 34835040 PMCID: PMC8623401 DOI: 10.3390/v13112234] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 12/21/2022] Open
Abstract
Human papillomaviruses (HPVs), which are small, double-stranded, circular DNA viruses infecting human epithelial cells, are associated with various benign and malignant lesions of mucosa and skin. Intensive research on the oncogenic potential of HPVs started in the 1970s and spread across Europe, including Croatia, and worldwide. Nowadays, the causative role of a subset of oncogenic or high-risk (HR) HPV types, led by HPV-16 and HPV-18, of different anogenital and head and neck cancers is well accepted. Two major viral oncoproteins, E6 and E7, are directly involved in the development of HPV-related malignancies by targeting synergistically various cellular pathways involved in the regulation of cell cycle control, apoptosis, and cell polarity control networks as well as host immune response. This review is aimed at describing the key elements in HPV-related carcinogenesis and the advances in cancer prevention with reference to past and on-going research in Croatia.
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Gupta I, Ulamec M, Peric-Balja M, Ramic S, Al Moustafa AE, Vranic S, Al-Farsi HF. Presence of high-risk HPVs, EBV, and MMTV in human triple-negative breast cancer. Hum Vaccin Immunother 2021; 17:4457-4466. [PMID: 34623225 PMCID: PMC8828071 DOI: 10.1080/21645515.2021.1975452] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Breast cancer, the most frequent disease amongst women worldwide, accounts for the highest cancer-related mortality rate. Triple-negative breast cancer (TNBC) subtype encompasses ~15% of all breast cancers and lack estrogen, progesterone, and HER2 receptors. Although risk factors for breast cancer are well-known, factors underpinning breast cancer onset and progression remain unknown. Recent studies suggest the plausible role of oncoviruses including human papillomaviruses (HPVs), Epstein-Barr virus (EBV), and mouse mammary tumor virus (MMTV) in breast cancer pathogenesis. However, the role of these oncoviruses in TNBC is still unclear. In the current study, we explored the status of high-risk HPVs, EBV, and MMTV in a well-defined TNBC cohort from Croatia in comparison to 16 normal/non TNBC samples (controls) using polymerase chain reaction assay. We found high-risk HPVs and EBV present in 37/70 (53%) and 25/70 (36%) of the cases, respectively. The most common HPV types are 52, 45, 31, 58 and 68. We found 16% of the samples positive for co-presence of high-risk HPVs and EBV. Moreover, our data revealed that 5/70 (7%) samples are positive for MMTV. In addition, only 2/70 (3%) samples had co-presence of HPVs, EBV, and MMTV without any significant association with the clinicopathological variables. While, 6/16 (37.5%) controls were positive for HPV (p = .4), EBV was absent in all controls (0/16, 0%) (p = .01). In addition, we did not find the co-presence of the oncoviruses in the controls (p > .05). Nevertheless, further investigations are essential to understand the underlying mechanisms of multiple-oncogenic viruses' interaction in breast carcinogenesis, especially TNBC.
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Affiliation(s)
- Ishita Gupta
- College of Medicine, Qu Health, Qatar University, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, Qu Health, Qatar University, Doha, Qatar
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
| | - Monika Ulamec
- College of Medicine, Qu Health, Qatar University, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, Qu Health, Qatar University, Doha, Qatar
- Ljudevit Jurak Clinical Department of Pathology and Cytology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
- Department of Pathology and Scientific Group for Research on Epigenetic Biomarkers, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Melita Peric-Balja
- College of Medicine, Qu Health, Qatar University, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, Qu Health, Qatar University, Doha, Qatar
- Oncological Pathology Department, Ljudevit Jurak Clinical Department of Pathology and Cytology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Snjezana Ramic
- College of Medicine, Qu Health, Qatar University, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, Qu Health, Qatar University, Doha, Qatar
- Oncological Pathology Department, Ljudevit Jurak Clinical Department of Pathology and Cytology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ala-Eddin Al Moustafa
- College of Medicine, Qu Health, Qatar University, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, Qu Health, Qatar University, Doha, Qatar
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- CONTACT Ala-Eddin Al Moustafa College of Medicine, Qu Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Semir Vranic
- College of Medicine, Qu Health, Qatar University, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, Qu Health, Qatar University, Doha, Qatar
| | - Halema F. Al-Farsi
- College of Medicine, Qu Health, Qatar University, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, Qu Health, Qatar University, Doha, Qatar
- Halema F. Al-Farsi College of Medicine, Qu Health, Qatar University, PO Box2713, Doha, Qatar
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Lopicic M, Raonic J, Antunovic M, Milicic B, Mijovic G. Distribution of vaccine-related high-risk human papillomaviruses and their impact on the development of cervical dysplasia in women in Montenegro. Acta Microbiol Immunol Hung 2021:2021.01606. [PMID: 34735367 DOI: 10.1556/030.2021.01606] [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: 09/24/2021] [Accepted: 10/11/2021] [Indexed: 12/09/2022]
Abstract
Cervical cancer (CC) is the third leading cause of death in women in Montenegro. Human papillomavirus (HPV) is the causative agent of CC however, HPV genotype distribution varies across regions. This study examined the distribution and impact of vaccine-related high-risk (HR)-HPVs on the development of cervical dysplasia in Montenegrin women. A total of 187 women who had a clinical indication for cervical biopsy were enrolled. Based on histopathological findings, women were classified into 2 groups, with and without dysplasia. HR-HPV was detected by real-time PCR. Twelve HR-HPV genotypes were detected in 40.6% of cervical samples. The 7 most prevalent HR-HPVs in order of decreasing frequency were HPV 16 (39.5%), 45 (23.7%), 31 (21.0%), 33 (17.1%), 18 (6.6%), 52 (6.6%), and 58 (6.6%), all of them are targeted by nonavalent vaccine. Vaccine-related HR-HPVs had a higher prevalence (92.1%) than the other HR-HPVs detected in HR-HPV-positive samples. Among HR-HPV-positive women, HPV 16 and 33 were more common in women with dysplasia than in those without dysplasia (HPV 16: 28.9 vs 7.2%; HPV 33: 11.8 vs 3.6%). HPV 16 was the most common HR-HPV genotype in cervical samples, followed by HPV 45, 31, 33, 18, 52, and 58. HPV 16 and 33 were shown to be associated with the development of cervical dysplasia. These results indicate that prophylactic nonavalent vaccine can potentially prevent approximately 90% of HR-HPV infections and 60% of cervical dysplasia cases in Montenegrin women.
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Affiliation(s)
- Milena Lopicic
- 1Institute of Public Health of Montenegro, Podgorica, Montenegro
| | - Janja Raonic
- 2Clinical Centre of Montenegro, Podgorica, Montenegro
| | | | | | - Gordana Mijovic
- 1Institute of Public Health of Montenegro, Podgorica, Montenegro
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Hu Y, Zhang X, He Y, Ma Z, Xie Y, Lu X, Xu Y, Zhang Y, Jiang Y, Xiao H, Struyf F, Folschweiller N, Jiang J, Poncelet S, Karkada N, Jastorff A, Borys D. Long‐term persistence of immune response to the AS04‐adjuvanted HPV‐16/18 vaccine in Chinese girls aged 9‐17 years: Results from an 8‐9‐year follow‐up phase III open‐label study. Asia Pac J Clin Oncol 2020; 16:392-399. [PMID: 32780946 PMCID: PMC7754390 DOI: 10.1111/ajco.13398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 05/21/2020] [Indexed: 11/29/2022]
Abstract
Aim In 9‐17‐year‐old Chinese girls, the AS04‐adjuvanted HPV‐16/18 vaccine (AS04‐HPV‐16/18) given as three‐dose schedule induced high antibody levels, which were noninferior 1 month after the third dose to those observed in 18‐25‐year‐old Chinese women in a large efficacy study. We assessed the persistence of antibodies 8‐9 years after vaccination in the same subjects. Methods This follow‐up phase III, open‐label study (NCT03355820) included subjects who had received three doses of AS04‐HPV‐16/18 in the initial trial (NCT00996125). Serum antibody concentrations were assessed by ELISA and compared to antibody persistence observed in 18‐25‐year‐old Chinese women 6 years after first vaccination in the efficacy study (NCT00779766). Results Out of the 227 enrolled subjects, 223 were included in the per‐protocol immunogenicity analysis. Mean interval from first AS04‐HPV‐16/18 dose to blood sampling was 101.4 months (8.5 years). For antibodies against HPV‐16 and ‐18, 8.5 years after first vaccine dose all subjects remained seropositive and antibody. Geometric mean concentrations (GMCs) were 1236.3 (95% confidence interval [CI]: 1121.8; 1362.4) and 535.6 (95% CI: 478.6; 599.4) ELISA Units/mL, respectively. These seropositivity rates and antibody GMCs were higher than those observed 6 years after first vaccination of 18‐25‐year‐old women. Conclusion Sustained anti‐HPV‐16 and ‐18 immune responses were observed 8‐9 years after AS04‐HPV‐16/18 vaccination of 9‐17 year‐old Chinese girls that were higher than the ones observed 6 years after first vaccination in Chinese adult women in whom AS04‐HPV‐16/18 efficacy against cervical intraepithelial neoplasia of grade ≥2 was demonstrated.
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Affiliation(s)
- Yuemei Hu
- Jiangsu Province Center for Disease Control and Prevention Jiangsu China
| | - Xiang Zhang
- Taizhou City Center for Disease Control and Prevention Taizhou China
| | - Yilin He
- Taizhou City Center for Disease Control and Prevention Taizhou China
| | - Zhilong Ma
- Taizhou City Center for Disease Control and Prevention Taizhou China
| | - Yan Xie
- Taizhou City Center for Disease Control and Prevention Taizhou China
| | - Xiangbin Lu
- Taizhou City Center for Disease Control and Prevention Taizhou China
| | - Yabin Xu
- Taizhou City Center for Disease Control and Prevention Taizhou China
| | - Yanqiu Zhang
- Taizhou City Center for Disease Control and Prevention Taizhou China
| | - Yunyu Jiang
- Taizhou City Center for Disease Control and Prevention Taizhou China
| | - Hui Xiao
- Taizhou City Center for Disease Control and Prevention Taizhou China
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Karani LW, Musyoki S, Orina R, Nyamache AK, Khayeka-Wandabwa C, Nyagaka B. Human papillomavirus genotype profiles and cytological grades interlinkages in coinfection with HIV. Pan Afr Med J 2020; 35:67. [PMID: 32537071 PMCID: PMC7250203 DOI: 10.11604/pamj.2020.35.67.21539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 02/23/2020] [Indexed: 01/03/2023] Open
Abstract
Introduction The study aimed to examine and characterize human papilloma virus (HPV) cytological grade trends and genotypes among HPV/HIV co-infected/cases and HPV monoinfected/control women attending Kisii Teaching and Referral Hospital, Kenya. Methods HIV positive co-infected with HPV (HPV/HIV) and HIV negative women monoinfected with HPV profiled as co-infected/cases and monoinfected/control arms respectively were enrolled. HPV subtypes were assayed by Xpert® HPV system (GXHPV-CE-10) alongside pathological cytology analysis of cervical tissue samples. Results Low grade intraepithelial lesion (LSIL) was the most predominant cytological grade across cases and controls with a prevalence of 32 (38.1%) while high grade squamous intraepithelial lesion (HSIL) was highest among HPV/HIV co-infected with a prevalence of 23 (27.38%). Among the monoinfected (controls) the predominant lesion was low grade intraepithelial lesions (LSIL) with a prevalence of 23 (27.38%). HPV type 16 had the highest prevalence 26 (30.8%) among the VIA positive women in the overall study participants followed by combinations of HPV types (16, 18/45) at 19 (22.6%). Conclusion High risk HPV types 16 and 18/45 were the most predominant in the established cytological grades and among the co-infected women. Routine screening using both cytological and HPV testing should be embraced and/or reinforced as early screening and preventive strategies in the covered geographical region population. Provision of the currently available vaccines to these women at an early age would provide effective protection since the HPV type profiles in this population are covered by such vaccines.
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Affiliation(s)
| | | | - Robert Orina
- School of Health Science, Kisii University, Kisii, Kenya
| | | | - Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin 300072, China
| | - Benuel Nyagaka
- School of Health Science, Kisii University, Kisii, Kenya
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Campos RG, Malacara Rosas A, Gutiérrez Santillán E, Delgado Gutiérrez M, Torres Orozco RE, García Martínez ED, Torres Bernal LF, Rosas Cabral A. Unusual prevalence of high-risk genotypes of human papillomavirus in a group of women with neoplastic lesions and cervical cancer from Central Mexico. PLoS One 2019; 14:e0215222. [PMID: 30998701 PMCID: PMC6474327 DOI: 10.1371/journal.pone.0215222] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/28/2019] [Indexed: 12/18/2022] Open
Abstract
Human papillomavirus has been identified as a main etiological agent in the
development of cervical cancer. HPV 16 and 18 have been reported the most widely
prevalent genotypes worldwide. We conducted a study analyzing the prevalence of
high and low risk human papillomavirus viral types in the Mexican state of
Aguascalientes and neighboring cities in the states of Jalisco and Zacatecas in
central Mexico. Specific viral genotype was determined by a PCR and
hybridization-based detection test. The presence of 37 high- and low-risk HPV
genotypes was evaluated in 883 female participants. Of these, 350 presented
low-grade squamous intraepithelial lesions (LGSIL), 176 presented high-grade
squamous intraepithelial lesions (HGSIL), 107 suffered from cervical cancer and
250 women with negative cytological report for intraepithelial lesion or
malignancy (NILM). HPV 51 was the most prevalent genotype, followed by HPV 16:
overall prevalence of HPV 51, including single infections and co-infections was
31.2% in women with LGSIL, whereas prevalence of HPV 16 was 25.1%. Among women
with HGSIL, HPV 51 prevalence was 47.2% and HPV 16 was 30.1%. Prevalence of HPV
51 in women with cervical cancer was 49.5% and type 16 was 33.6%. Between single
and co-infections, most co-infections were not associated with later stages of
the disease, except 51/16 and some others. HPV 51 showed a significant
correlation with the progression of the disease (OR = 10.81 for LGSIL, 19.38 for
HGSIL and 22.95 for ICC), and when analyzing all other genotypes, five different
groups depending on their correlation with all lesion grades were determined.
According to our findings, HPV genotype 51 has a higher prevalence than HPV 16
and 18 in the Mexican state of Aguascalientes and neighboring cities in the
states of Jalisco and Zacatecas in Central Mexico.
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Affiliation(s)
- Rafael Gutiérrez Campos
- Department of Chemistry, Center for Basic Sciences, Autonomous University
of Aguascalientes, Aguascalientes, Aguascalientes, México
- * E-mail:
| | - Angélica Malacara Rosas
- Department of Chemistry, Center for Basic Sciences, Autonomous University
of Aguascalientes, Aguascalientes, Aguascalientes, México
| | - Elvia Gutiérrez Santillán
- Hospital General de Zona Número 6, Instituto Mexicano del Seguro Social,
Monterrey, Nuevo León, México
| | - Mireya Delgado Gutiérrez
- Hospital General de Zona Número 1, Instituto Mexicano del Seguro Social,
Aguascalientes, Aguascalientes, México
| | - Rusland Enrique Torres Orozco
- Department of Chemistry, Center for Basic Sciences, Autonomous University
of Aguascalientes, Aguascalientes, Aguascalientes, México
| | - Elí Daniel García Martínez
- Department of Chemistry, Center for Basic Sciences, Autonomous University
of Aguascalientes, Aguascalientes, Aguascalientes, México
| | - Luis Fernando Torres Bernal
- Department of Medicine, Center for Health Sciences, Autonomous University
of Aguascalientes, Aguascalientes, México
| | - Alejandro Rosas Cabral
- Department of Medicine, Center for Health Sciences, Autonomous University
of Aguascalientes, Aguascalientes, México
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Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing. Viruses 2018; 10:v10120729. [PMID: 30572620 PMCID: PMC6315375 DOI: 10.3390/v10120729] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/12/2018] [Accepted: 12/15/2018] [Indexed: 12/25/2022] Open
Abstract
Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.
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