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Liu H, Lin X, Zhu X, Zhang Q, Wei Y, Ma G. Modeling and analysis of a human papilloma virus transmission model with impact of media. Math Biosci 2024; 375:109247. [PMID: 38969058 DOI: 10.1016/j.mbs.2024.109247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 06/12/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024]
Abstract
The human papillomavirus (HPV) is threatening human health as it spreads globally in varying degrees. On the other hand, the speed and scope of information transmission continues to increase, as well as the significant increase in the number of HPV-related news reports, it has never been more important to explore the role of media news coverage in the spread and control of the virus. Using a decreasing factor that captures the impact of media on the actions of people, this paper develops a model that characterizes the dynamics of HPV transmission with media impact, vaccination and recovery. We obtain global stability of equilibrium points employing geometric method, and further yield effective methods to contain the HPV pandemic by sensitivity analysis. With the center manifold theory, we show that there is a forward bifurcation when R0=1. Our study suggested that, besides controlling contact between infected and susceptible populations and improving effective vaccine coverage, a better intervention would be to strengthen media coverage. In addition, we demonstrated that contact rate and the effect of media coverage result in multiple epidemics of infection when certain conditions are met, implying that interventions need to be tailored to specific situations.
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Affiliation(s)
- Hua Liu
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, Gansu 730030, China.
| | - Xiaofen Lin
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, Gansu 730030, China
| | - Xinjie Zhu
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, Gansu 730030, China
| | - Qibin Zhang
- Gansu High-Tech Innovation Service Center, Lanzhou, Gansu 730030, China
| | - Yumei Wei
- Experimental Teaching Deparment, Northwest Minzu University, Lanzhou, Gansu 730030, China
| | - Gang Ma
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, Gansu 730030, China
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Trott S, Lei F, Jay Christian W, Mao X, Lehmkuhl B, Kejner A. Geographic variation of HPV-associated cancer incidence in Kentucky using spatial scan statistics. Cancer Causes Control 2024; 35:817-824. [PMID: 38212533 PMCID: PMC11346267 DOI: 10.1007/s10552-023-01835-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 11/22/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE Populations with high cancer risk that are targeted for screening, education, and vaccination have been shown to increase rates of screening, which ultimately may improve timing of diagnosis and overall outcome for certain cancers. Spatial scan analysis provides a visual representation of areas with higher rates of disease. Limited research has used this methodology to assess HPV-associated cancers. Using, spatial scan statistics, our goal was to identify regions within Kentucky having significantly higher rates of HPV-associated tumors. These regions can be targeted for public health efforts in the form of education, vaccination, screening, and physician recruitment. METHODS The Kentucky Cancer Registry data from 1995 to 2016 and spatial scan statistics were used to identify county-level clusters with high-incidence of HPV-associated cancers after adjustment for age and sex. Anatomic sites included in this analysis were oropharynx, cervix, anus, penis, and vulva. RESULTS There was one high-rate cluster of oropharyngeal cancer, which was observed in the Louisville metropolitan region (Relative Risk [RR] = 1.24, p < 0.001). One high-rate cluster of anal and penile cancer incidence in men was identified that partially overlapped with the oropharyngeal cluster. There were five clusters of higher cervical, vulvar, and anal cancer incidence in females, one of which overlapped with the oropharyngeal cluster. CONCLUSION Overlapping clusters of HPV-associated cancers were identified at the county-level and included both urban and rural counties of Kentucky. Findings can assist in the design of public health interventions to increase screenings, promote vaccination, and recruit physicians in these regions to improve prevention, diagnosis, and early treatment of HPV-associated cancers.
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Affiliation(s)
- Skylar Trott
- Department of Otolaryngology, University of Kentucky, Lexington, KY, USA
| | - Feitong Lei
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - W Jay Christian
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA
| | - Xihua Mao
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA
| | - Ben Lehmkuhl
- Department of Otolaryngology, University of Kentucky, Lexington, KY, USA
| | - Alexandra Kejner
- Department of Otolaryngology, Medical University of South Carolina, Charleston, SC, USA.
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Tilahun S, Wondiye H, Anteneh Yigzaw Z. Mothers' intention to vaccinate their daughters against human papillomavirus in NorthWest Ethiopia, using the theory of planned behavior. Hum Vaccin Immunother 2023; 19:2288390. [PMID: 38111322 PMCID: PMC10760316 DOI: 10.1080/21645515.2023.2288390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/23/2023] [Indexed: 12/20/2023] Open
Abstract
Human papillomavirus (HPV) is the second most common cause of cancer worldwide among females. HPV vaccination is highly protective against HPV infection and can reduce 56% of HPV infections. Therefore, the study aims to assess mothers' intention to vaccinate their daughters aged 9-14 years old against human papillomavirus in Debre Tabor town, Northwest Ethiopia, using the theory of planned behavior. A community-based cross-sectional study design was employed using the theory of planned behavior from November 1 to 30, 2022, in Northwest Ethiopia. A total sample of 449 study participants was enrolled. The study participants were selected using a multi-stage random sampling technique. Data was collected using an interview-administered questionnaire. The data was entered into EPI data version 4.6 and then, exported to SPSS version 23 for analysis. Those variables with a p-value <.05 with 95% CI were considered significant predictors. Mothers' positive intention to vaccinate their daughters aged 9-14 years against HPV was 67.5%. Attitude, perceived behavioral control, and subjective norm were significant predictors with (AOR = 10.09, 95% CI = 6.23-16.32), (AOR = 4.12, 95% CI = 2.71-6.26), and (AOR = 16.397, 95% CI = 9.69-27.748), respectively. Only two-thirds of mothers have a positive intention to vaccinate their daughters against human papillomavirus. Attitude, perceived behavioral control, and subjective norm were predictors. Therefore, it is better to do community mobilization toward the advantage of HPV vaccination.
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Affiliation(s)
- Samrawit Tilahun
- Communicable and Noncommunicable Disease Prevention and Control Office, Tesfaye Getachew Primary Hospital, South Gondar, Ethiopia
| | - Habtamu Wondiye
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Zeamanuel Anteneh Yigzaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Ikpeni O(T, Maraj D, Woods H, Workentin A, Booth CM, Persaud N. Essential cancer medicines and cancer outcomes: Cross-sectional study of 124 countries. Cancer Med 2023; 12:20745-20758. [PMID: 37902259 PMCID: PMC10709725 DOI: 10.1002/cam4.6642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/03/2023] [Accepted: 10/12/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Cancer is the second leading cause of death worldwide. Alongside other interventions, access to certain medicines may decrease cancer-associated mortality. Listing medicines on national essential medicines lists may improve health outcomes. We examine the association between cancer mortality amenable to care and the listing of cancer medicines on national essential medicines lists (NEMLs) of 124 countries. METHODS In this cross-sectional study, we determined the number of medicines used to treat eight cancers on NEMLs and used multiple linear regression to analyze the association between cancer health outcome scores and the number of medicines on NEMLs while controlling for GDP. A sensitivity analysis was also conducted using selected medicines. FINDINGS The number of cancer medicines on NEMLs was not associated with cancer health outcome scores when GDP was controlled for non-melanoma skin (p = 0.224), uterine (p = 0.221), breast (p = 0.145), Hodgkin's lymphoma (p = 0.697), colon (p = 0.299), leukemia (p = 0.103), cervical (p = 0.834), and testicular cancers (p = 0.178). INTERPRETATION There was a weak association between listing medicines for eight cancers in NEMLs and amenable mortality. Further studies are required to explore association between cancer health outcomes and other factors such as actual availability of medicines listed, access to surgeries, accurate diagnosis, radiotherapy, and early detection.
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Affiliation(s)
| | - Darshanand Maraj
- MAP Centre for Urban Health SolutionsSt. Michael's HospitalTorontoOntarioCanada
| | - Hannah Woods
- MAP Centre for Urban Health SolutionsSt. Michael's HospitalTorontoOntarioCanada
| | - Aine Workentin
- MAP Centre for Urban Health SolutionsSt. Michael's HospitalTorontoOntarioCanada
| | | | - Nav Persaud
- MAP Centre for Urban Health SolutionsSt. Michael's HospitalTorontoOntarioCanada
- Department of Family and Community MedicineUniversity of TorontoTorontoOntarioCanada
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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.
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Affiliation(s)
| | | | | | | | | | - Eithar A Alali
- Obstetrics and Gynaecology, King Faisal University, Alhofuf, SAU
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Taylor-Cousar JL, Shteinberg M, Cohen-Cymberknoh M, Jain R. The Impact of Highly Effective Cystic Fibrosis Transmembrane Conductance Regulator Modulators on the Health of Female Subjects With CF. Clin Ther 2023; 45:278-289. [PMID: 36841738 DOI: 10.1016/j.clinthera.2023.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/28/2022] [Accepted: 01/31/2023] [Indexed: 02/26/2023]
Abstract
Cystic fibrosis (CF) is a genetic disorder that occurs in people of all genetic ancestries. CF is caused by variants in the CF transmembrane conductance regulator (CFTR) gene that result in decreased, absent, or nonfunctional CFTR protein at the cell surface of the mucous membranes. Clinical manifestations include chronic respiratory disease, malabsorption, and decreased fertility. Historically, therapies for CF were focused on the signs and symptoms of the disease. However, more recently, CFTR modulators, therapies directed at the basic defect, are improving the quality and duration of the lives of people with CF. The predicted survival of people with CF in the United States is now 53 years of age. With the hope of longer, healthier lives, female individuals with CF (fwCF) are expressing the desire to discuss fertility, pregnancy, and parenthood. Furthermore, pregnancy rates are increasing substantially. Understanding the impact of use or discontinuation of highly effective modulator therapy on the reproductive health of fwCF is critical. Finally, fwCF and their providers must consider preventative cancer screening. (Clin Ther. 2023;45:XXX-XXX) © 2023 Elsevier HS Journals, Inc.
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Affiliation(s)
- Jennifer L Taylor-Cousar
- Division of Pulmonary, Critical Care and Sleep Medicine and of Pediatric Pulmonary Medicine, National Jewish Health, Denver, CO, USA.
| | - Michal Shteinberg
- Technion-Israel Institute of Technology and the B. Rappaport Faculty of Medicine, Haifa, Israel; Pulmonology Institute and CF Center, Carmel Medical Center, Haifa, Israel
| | - Malena Cohen-Cymberknoh
- Pediatric Pulmonology Unit and Cystic Fibrosis Center, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Raksha Jain
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Katz J, Labilloy A, Lee A. Recurrent, non-traumatic, non-exertional rhabdomyolysis after immunologic stimuli in a healthy adolescent female: a case report. BMC Pediatr 2022; 22:515. [PMID: 36042458 PMCID: PMC9426381 DOI: 10.1186/s12887-022-03561-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Dysferlinopathy refers to a heterogenous group of autosomal recessive disorders that affect a skeletal muscle protein called dysferlin. These mutations are associated with limb-girdle muscular dystrophy type 2B, Miyoshi myopathy, asymptomatic hyperCKemia, and distal myopathy with anterior tibial onset. Case presentation A 16 year old female presented with myalgia, weakness and dark urine one week after her second BNT162b2 mRNA (Pfizer) vaccine. Initial serum creatine kinase (CK) was measured at 153,000 IU/L, eventually up-trending to over 200,000 IU/L. However, stable renal function precluded hemodialysis allowing discharge after 10 days of intravenous (IV) hydration and alkaline diuresis. Just two years prior to the current presentation, the patient was hospitalized following Group A Streptococcal pharyngitis infection complicated by rhabdomyolysis. She presented with fatigue, lower extremity weakness, and dark oliguria with CK measuring 984,800 IU/L. IV hydration was attempted however hemodialysis was ultimately required throughout her 24-day hospital stay. Her episode was presumed to be idiopathic and no further work-up was performed at that time. During the patient’s current hospitalization, she reported similar symptomology (myalgias and weakness) following her first quadrivalent Gardasil vaccine at age 11. No hospitalization was required at that time. A comprehensive workup was now initiated while the patient was being treated for her suspected second or third non-exertional, non-traumatic rhabdomyolysis. Rheumatologic, metabolic, infectious, and endocrinologic workup were all unremarkable. Patient eventually had whole exome sequencing performed which revealed a heterozygous pathogenic variant in the DYSF gene (DYSF c.2643 + 1G > A) encoding dysferlin. No clinically significant sequelae occurred thus far. Conclusions While there have been reports of symptomatic heterozygote carriers of dysferlinopathies, to our knowledge none have been associated with recurrent rhabdomyolysis after immunogenic stimuli. This unique case presentation highlights the importance of a multi-disciplinary care team, the utility of modern whole-exome gene sequencing, and the future challenges of balancing vaccine risk vs benefit. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03561-2.
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Affiliation(s)
- Jason Katz
- College of Medicine, UF College of Medicine, Gainesville, FL, 32610, USA.
| | - Anatalia Labilloy
- Department of Pediatrics, Division of Pediatric Genetics, UF College of Medicine, Jacksonville, FL, 32207, USA
| | - Andrew Lee
- Department of Pediatrics, Division of General Pediatrics, UF College of Medicine, Jacksonville, FL, 32217, USA
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The Leaf Extract of Mitrephora chulabhorniana Suppresses Migration and Invasion and Induces Human Cervical Cancer Cell Apoptosis through Caspase-Dependent Pathway. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2028082. [PMID: 35655474 PMCID: PMC9152413 DOI: 10.1155/2022/2028082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 04/11/2022] [Accepted: 04/20/2022] [Indexed: 12/20/2022]
Abstract
Cervical cancer is rated to be the leading cause of cancer-related death in women worldwide. Since screening test and conventional treatments are less accessible for people in developing countries, an alternative use of medicinal plants exhibiting strong anticancer activities may be an affordable means to treat cervical cancer. Mitrephora chulabhorniana (MC) is the newly identified species; however, its biological functions including anticancer activities have been largely unexplored. Hence, in this study, we were interested in investigating anticancer effects of this plant on the human cervical cell line (HeLa). MC extract was profiled for phytochemicals by TLC. This plant was tested to contain alkaloids, flavonoids, and terpenes. HeLa cells were treated with MC extract to investigate the anticancer activities. Cytotoxicity and viability of cells treated with MC were determined by MTT assay and Trypan blue exclusion assay. Cell migration was tested by wound healing assay, and cell invasion was determined by Transwell assay. The level of caspase 7, caspase 9, and PARP was determined by western blot analysis. We found that the leaf extract of MC strongly reduced cancer cell survival rate. This finding was consistent with the discovery that the extract dramatically induced apoptosis of cervical cancer cells through the activation of caspase 7 and caspase 9 which consequently degraded PARP protein. Furthermore, MC extract at lower concentrations which were not cytotoxic to the cancer cells showed potent inhibitory activities against HeLa cervical cancer cell migration and invasion. Mitrephora chulabhorniana possesses its pharmacological properties in inhibiting cervical cancer cell migration/invasion and inducing apoptotic signaling. This accumulated information suggests that Mitrephora chulabhorniana may be a beneficial source of potential agents for cervical cancer treatment.
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Song SY, Lee SY, Ko YB, Kim J, Choi TY, Lee KH, Yoo HJ, Yuk JM. Fenofibrate Exerts Anticancer Effects on Human Cervical Cancer HeLa Cells via Caspase-Dependent Apoptosis and Cell Cycle Arrest. Gynecol Obstet Invest 2022; 87:79-88. [DOI: 10.1159/000518509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/02/2021] [Indexed: 11/19/2022]
Abstract
<b><i>Objective:</i></b> In the present study, we attempted to identify the effects of fenofibrate on human cervical cancer cells. <b><i>Methods:</i></b> The cytotoxicity of fenofibrate in cervical cancer cells was determined by Cell Counting Kit-8. Immunoblotting assay was used to determine the protein expression of caspase-3, poly ADP-ribose polymerase cleavage, B-cell lymphoma 2 family protein expression, microtubule-associated protein 1A/1B-light chain 3 (LC3), as well as cyclins and cyclin-dependent kinases. Immunofluorescence imaging was used to determine the expression of cleaved caspase-3 and LC3. Flow cytometry was used to determine cell cycle and apoptosis. <b><i>Results:</i></b> We first showed that fenofibrate treatment reduced cell viability in HeLa cervical cancer cells in a dose-dependent manner at 24 h and 48 h. Importantly, fenofibrate-induced cell death was mediated through cell cycle arrest in the G0–G1 phase and caspase-dependent apoptosis. Moreover, fenofibrate also induced autophagy activation in a dose-dependent manner and pharmacological inhibition of autophagy led to increase of sub-G1 phase and caspase-dependent cell death in HeLa cells. <b><i>Conclusion:</i></b> In conclusion, these data demonstrated that fenofibrate initially induced cell cycle arrest, followed by caspase-3-dependent cell death in cervical cancer HeLa cells. However, fenofibrate also induced autophagy activation, which is closely related to the survival of diverse cancer cells, thus reducing the anticancer effects of fenofibrate. Therefore, the combination of an autophagy inhibitor and fenofibrate might have the potential to become a new therapeutic strategy for cervical cancer.
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Cervical Intraepithelial Neoplasia Grade 3 in a HPV-Vaccinated Patient: A Case Report. Medicina (B Aires) 2022; 58:medicina58030339. [PMID: 35334516 PMCID: PMC8949814 DOI: 10.3390/medicina58030339] [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: 01/27/2022] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 11/16/2022] Open
Abstract
Persistent infection with human papillomavirus (HPV) causes almost all cervical precancerous lesions and cancers. Bivalent, quadrivalent, and nonavalent HPV vaccines effectively prevent high-grade cervical intraepithelial neoplasia (CIN3). The effectiveness of HPV vaccination against CIN3 is 97–100% in HPV-naïve populations and 44–61% in the overall population. Although HPV vaccination has substantially reduced the incidence of cervical cancers, several cases of precancerous cervical lesions in HPV-vaccinated patients have been reported. We report the clinical case of a 19-year-old woman whose first Pap smear was diagnosed as a high-grade squamous intraepithelial lesion (HSIL) after quadrivalent HPV vaccination. Colposcopy and cervical biopsy were performed, revealing HSIL/CIN3. Our multidisciplinary team decided to take a conservative approach with follow-up visits with cervical biopsies of this young patient. After six months, spontaneous regression of high-grade cervical dysplasia was observed. Although HPV immunization has shown to be extremely effective in preventing a high proportion of cervical precancerous lesions and cervical cancers, HPV vaccines do not protect against all oncogenic high-risk HPV genotypes. Consequently, healthcare providers must encourage HPV-vaccinated women to still regularly attend national cervical screening programs.
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Inequalities in Mortality and Access to Hospital Care for Cervical Cancer-An Ecological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010966. [PMID: 34682711 PMCID: PMC8535933 DOI: 10.3390/ijerph182010966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/03/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022]
Abstract
Cervical cancer is the second most common form of cancer in the world among women, and it is estimated to be the third most frequent cancer in Brazil, as well as the fourth leading cause of death from cancer. There is a difference in cervical cancer mortality rates among different administrative regions in Brazil along with an inadequate distribution of cancer centers in certain Brazilian regions. Herein, we analyze the trends in hospital admission and mortality rates for CC between 2000 and 2012. This population-based ecological study evaluated the temporal trend in cervical cancer between the years 2000 and 2012, stratifying by Brazilian administrative regions. The North and Northeast regions had no reduction in mortality in all age groups studied (25 to 64 years); when analyzing hospitalization rates, only the age group of 50 to 64 years from the North Region did not present a reduction. During the years studied, in the South Region, the age group ranging from 50 to 54 years had the greatest reduction in mortality rates (β = −0.59, p = 0.001, r2 = 0.63), and the group ranging from 45 to 49 years had the greatest reduction in hospital admission rates (β = −8.87, p = 0.025, r2 = 0.37). Between the years 2000 and 2012, the greatest reduction in the incidence of UCC was in the South Region (β = −1.43, p = 0.236, r2 = 0.12) followed by the Central-West (β = −1, p < 0.001, r2 = 0.84), the Southeast (β = −0.95, p < 0.001, r2 = 0.88), the Northeast (β = −0.67, p = 0.080, r2 = 0.25), and, finally, by the North (β = −0.42, p = 0.157, r2 = 0.17). There was a greater reduction in mortality rates and global hospitalization rates for CC in Brazil than in the United States during the same period with exceptions only in Brazil’s North and Northeast regions.
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Boesch M, Baty F, Rothschild SI, Tamm M, Joerger M, Früh M, Brutsche MH. Tumour neoantigen mimicry by microbial species in cancer immunotherapy. Br J Cancer 2021; 125:313-323. [PMID: 33824481 PMCID: PMC8329167 DOI: 10.1038/s41416-021-01365-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 02/02/2021] [Accepted: 03/10/2021] [Indexed: 02/08/2023] Open
Abstract
Tumour neoantigens arising from cancer-specific mutations generate a molecular fingerprint that has a definite specificity for cancer. Although this fingerprint perfectly discriminates cancer from healthy somatic and germline cells, and is therefore therapeutically exploitable using immune checkpoint blockade, gut and extra-gut microbial species can independently produce epitopes that resemble tumour neoantigens as part of their natural gene expression programmes. Such tumour molecular mimicry is likely not only to influence the quality and strength of the body's anti-cancer immune response, but could also explain why certain patients show favourable long-term responses to immune checkpoint blockade while others do not benefit at all from this treatment. This article outlines the requirement for tumour neoantigens in successful cancer immunotherapy and draws attention to the emerging role of microbiome-mediated tumour neoantigen mimicry in determining checkpoint immunotherapy outcome, with far-reaching implications for the future of cancer immunotherapy.
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Affiliation(s)
| | - Florent Baty
- Lung Center, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Sacha I Rothschild
- Department of Medical Oncology and Comprehensive Cancer Center, University Hospital of Basel, Basel, Switzerland
| | - Michael Tamm
- Department of Pulmonology, University Hospital of Basel, Basel, Switzerland
| | - Markus Joerger
- Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Martin Früh
- Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Medical Oncology, University Hospital Bern, Bern, Switzerland
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Bitarafan F, Hekmat MR, Khodaeian M, Razmara E, Ashrafganjoei T, Modares Gilani M, Mohit M, Aminimoghaddam S, Cheraghi F, Khalesi R, Rajabzadeh P, Sarmadi S, Garshasbi M. Prevalence and Genotype Distribution of Human Papillomavirus Infection among 12,076 Iranian Women. Int J Infect Dis 2021; 111:295-302. [PMID: 34343706 DOI: 10.1016/j.ijid.2021.07.071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Human papillomavirus (HPV) infection is one of the major health concerns of women in developing countries. This study gives an insight into the prevalence and genotype distribution of HPV infection and compares it with Pap smear results among Iranian women. METHODS In this study, 12,076 Iranian women underwent routine examination from November 2016 to November 2018 using HPV Direct Flow CHIP System for HPV DNA typing. Cytology methods were also undertaken for 5,138 samples. RESULTS Overall HPV prevalence was calculated at 38.68%. The most frequent HPV types were HPV 6, 16, 11, 62/81, 52, and 54, respectively; and, the most high-risk HPV types were HPV 16, 52, 18, 39, 31, and 51. These two groups represent about half of all HPV types detected-47% and 55%, respectively. Among individuals who underwent cytological tests, 135 individuals (2.63%) were cytologically positive. In this group, 81 individuals (60%) were HPV positive as well, 62 (76%) of whom were HR-HPV positive and among them, the most frequent type was HPV 16 (34%). CONCLUSION This study highlights the urgent need for public education and also early diagnosis using HPV screening tests to prevent cervical cancer.
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Affiliation(s)
| | | | | | - Ehsan Razmara
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Teheran, Iran
| | | | | | - Mitra Mohit
- Department of Obstetrics and Gynecology, Faculty of Medicine, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | | | | | - Raziyeh Khalesi
- Department of Medical Genetics, DeNA Laboratory, Tehran, Iran
| | | | - Soheila Sarmadi
- Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Garshasbi
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Teheran, Iran.
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14
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McCoy KD, Weldon CT, Ansumana R, Lamin JM, Stenger DA, Ryan SJ, Bardosh K, Jacobsen KH, Dinglasan RR. Are malaria transmission-blocking vaccines acceptable to high burden communities? Results from a mixed methods study in Bo, Sierra Leone. Malar J 2021; 20:183. [PMID: 33849572 PMCID: PMC8045381 DOI: 10.1186/s12936-021-03723-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 04/04/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Malaria transmission-blocking vaccines (TBVs) could help break the cycle of malaria transmission by conferring community rather than individual protection. When introducing new intervention strategies, uptake is dependent on acceptability, not just efficacy. In this exploratory study on acceptability of TBVs in Sierra Leone, it was hypothesized that TBVs would be largely acceptable to adults and health workers in areas with relatively few ongoing malaria interventions, and that (i) knowledge of malaria and vaccines, (ii) health behaviours associated with malaria and vaccines, and (iii) attitudes towards different vaccines types could lead to greater TBV acceptability. METHODS This study used a mixed methods approach in Bo, Sierra Leone, to understand community knowledge, attitudes, and practices related to malaria and vaccination in general. This included: (i) a population-based cross-sectional survey (n=615 adults), (ii) 6 focus group discussions with parents, and (iii) 20 key informant interviews. The concept of a TBV was explained to participants before they were asked about their willingness to accept this vaccine modality as part of an integrated malaria elimination programme. RESULTS This study found that most adults would be willing to receive a TBV vaccine. Respondents noted mostly positive past experiences with adult and childhood vaccinations for other infectious diseases and high levels of engagement in other malaria prevention behaviors such as bed nets. Perceived barriers to TBV acceptance were largely focused on general community-level distribution of a vaccine, including personal fears of vaccination and possible costs. After an explanation of the TBV mechanism, nearly all focus group and interview participants believed that community members would accept the vaccine as part of an integrated malaria control approach. Both parents and health workers offered insight on how to successfully roll-out a future TBV vaccination programme. CONCLUSIONS The willingness of community members in Bo, Sierra Leone to accept a TBV as part of an integrated anti-malarial strategy suggests that the atypical mechanism of TBV action might not be an obstacle to future clinical trials. This study's findings suggests that perceived general barriers to vaccination implementation, such as perceived personal fears and vaccine cost, must be addressed in future clinical and implementation research studies.
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Affiliation(s)
- Kaci D McCoy
- CDC Southeastern Center of Excellence in Vector Borne Diseases, Gainesville, FL, USA
- Emerging Pathogens Institute, Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Caroline T Weldon
- CDC Southeastern Center of Excellence in Vector Borne Diseases, Gainesville, FL, USA
| | - Rashid Ansumana
- Mercy Hospital Research Laboratory, Bo, Sierra Leone
- School of Community Health Sciences, Njala University, Bo, Sierra Leone
| | | | - David A Stenger
- Center for Bio/Molecular Science and Engineering, Naval Research Laboratory, Washington, DC, USA
| | - Sadie J Ryan
- CDC Southeastern Center of Excellence in Vector Borne Diseases, Gainesville, FL, USA
- Emerging Pathogens Institute, Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
- Department of Geography, College of Liberal Arts & Sciences, University of Florida, Gainesville, FL, USA
| | - Kevin Bardosh
- Center for One Health Research, School of Public Health, University of Washington, Seattle, WA, USA
| | - Kathryn H Jacobsen
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Rhoel R Dinglasan
- CDC Southeastern Center of Excellence in Vector Borne Diseases, Gainesville, FL, USA.
- Emerging Pathogens Institute, Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
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15
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Osei EA, Appiah S, Gaogli JE, Oti-Boadi E. Knowledge on cervical cancer screening and vaccination among females at Oyibi Community. BMC WOMENS HEALTH 2021; 21:148. [PMID: 33845829 PMCID: PMC8042702 DOI: 10.1186/s12905-021-01296-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/07/2021] [Indexed: 11/13/2022]
Abstract
Background Awareness about cervical cancer screening and vaccination in the developed countries are high as compared to the developing countries. Sixty to eighty percent (60–80%) of the women who develop cervical cancer in sub-Saharan Africa live in the rural areas with inadequate awareness of cervical cancer screening. However, cervical cancer knowledge remained a significant direct predictor of screening behaviors. The study therefore aim to explore the Knowledge on Cervical Cancer Screening and Vaccination among females at Oyibi Community.
Methods A qualitative exploratory design was employed to purposively recruit 35 participants who were made up of 7 members in a group forming 5 Focus Group discussions in all. Data was retrieved using a semi-structured interview guide.
Results The study revealed two main themes with 7 subthemes. The two main themes were cervical cancer screening and vaccination knowledge and cervical cancer vaccination effectiveness and cost. The subthemes were; knowledge on cervical cancer screening types, knowledge about cervical cancer screening and vaccination centers, knowledge about how cancer screening is performed, knowledge about cervical cancer vaccination, cervical cancer screening and vaccination sources of information, knowledge about the effectiveness of cervical cancer vaccination and awareness about cervical cancer screening cost and vaccination cost.
Conclusion Ghanaian women are increasingly becoming aware of cervical cancer, nevertheless low knowledge on screening and vaccination of cervical cancer, and effectiveness was detected with high awareness about the screening and vaccination centers. There is therefore the need for heightened sensitization regarding cervical cancer screening and vaccination in rural communities to help reduce misconceptions and increase patronage rate. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01296-3.
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Affiliation(s)
- Evans Appiah Osei
- Department of Nursing, School of Nursing and Midwifery, Valley View University, P.O. Box DT 595, Oyibi, Ghana.
| | - Stella Appiah
- Department of Nursing, School of Nursing and Midwifery, Valley View University, P.O. Box DT 595, Oyibi, Ghana
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Zhang L, Zhao Y, Tu Q, Xue X, Zhu X, Zhao KN. The Roles of Programmed Cell Death Ligand-1/ Programmed Cell Death-1 (PD-L1/PD-1) in HPV-induced Cervical Cancer and Potential for their Use in Blockade Therapy. Curr Med Chem 2021; 28:893-909. [PMID: 32003657 DOI: 10.2174/0929867327666200128105459] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/13/2019] [Accepted: 12/14/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cervical cancer induced by infection with human papillomavirus (HPV) remains a leading cause of mortality for women worldwide although preventive vaccines and early diagnosis have reduced morbidity and mortality. Advanced cervical cancer can only be treated with either chemotherapy or radiotherapy but the outcomes are poor. The median survival for advanced cervical cancer patients is only 16.8 months. METHODS We undertook a structural search of peer-reviewed published studies based on 1). Characteristics of programmed cell death ligand-1/programmed cell death-1(PD-L1/PD-1) expression in cervical cancer and upstream regulatory signals of PD-L1/PD-1 expression, 2). The role of the PD-L1/PD-1 axis in cervical carcinogenesis induced by HPV infection and 3). Whether the PD-L1/PD-1 axis has emerged as a potential target for cervical cancer therapies. RESULTS One hundred and twenty-six published papers were included in the review, demonstrating that expression of PD-L1/PD-1 is associated with HPV-caused cancer, especially with HPV 16 and 18 which account for approximately 70% of cervical cancer cases. HPV E5/E6/E7 oncogenes activate multiple signalling pathways including PI3K/AKT, MAPK, hypoxia-inducible factor 1α, STAT3/NF-kB and microRNA, which regulate PD-L1/PD-1 axis to promote HPV-induced cervical carcinogenesis. The PD-L1/PD-1 axis plays a crucial role in the immune escape of cervical cancer through inhibition of host immune response. Creating an "immune-privileged" site for initial viral infection and subsequent adaptive immune resistance, which provides a rationale for the therapeutic blockade of this axis in HPV-positive cancers. Currently, Phase I/II clinical trials evaluating the effects of PDL1/ PD-1 targeted therapies are in progress for cervical carcinoma, which provide an important opportunity for the application of anti-PD-L1/anti-PD-1 antibodies in cervical cancer treatment. CONCLUSION Recent research developments have led to an entirely new class of drugs using antibodies against the PD-L1/PD-1 thus promoting the body's immune system to fight cancer. The expression and roles of the PD-L1/ PD-1 axis in the progression of cervical cancer provide great potential for using PD-L1/PD-1 antibodies as a targeted cancer therapy.
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Affiliation(s)
- Lifang Zhang
- School of Basic Medical Science, Wenzhou Medical University, Wenzhou, 325035 Zhejiang, China
| | - Yu Zhao
- Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, Zhejiang, China
| | - Quanmei Tu
- Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, Zhejiang, China
| | - Xiangyang Xue
- School of Basic Medical Science, Wenzhou Medical University, Wenzhou, 325035 Zhejiang, China
| | - Xueqiong Zhu
- Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, Zhejiang, China
| | - Kong-Nan Zhao
- School of Basic Medical Science, Wenzhou Medical University, Wenzhou, 325035 Zhejiang, China
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Kim JJ, Simms KT, Killen J, Smith MA, Burger EA, Sy S, Regan C, Canfell K. Human papillomavirus vaccination for adults aged 30 to 45 years in the United States: A cost-effectiveness analysis. PLoS Med 2021; 18:e1003534. [PMID: 33705382 PMCID: PMC7951902 DOI: 10.1371/journal.pmed.1003534] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 01/07/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND A nonavalent human papillomavirus (HPV) vaccine has been licensed for use in women and men up to age 45 years in the United States. The cost-effectiveness of HPV vaccination for women and men aged 30 to 45 years in the context of cervical cancer screening practice was evaluated to inform national guidelines. METHODS AND FINDINGS We utilized 2 independent HPV microsimulation models to evaluate the cost-effectiveness of extending the upper age limit of HPV vaccination in women (from age 26 years) and men (from age 21 years) up to age 30, 35, 40, or 45 years. The models were empirically calibrated to reflect the burden of HPV and related cancers in the US population and used standardized inputs regarding historical and future vaccination uptake, vaccine efficacy, cervical cancer screening, and costs. Disease outcomes included cervical, anal, oropharyngeal, vulvar, vaginal, and penile cancers, as well as genital warts. Both models projected higher costs and greater health benefits as the upper age limit of HPV vaccination increased. Strategies of vaccinating females and males up to ages 30, 35, and 40 years were found to be less cost-effective than vaccinating up to age 45 years, which had an incremental cost-effectiveness ratio (ICER) greater than a commonly accepted upper threshold of $200,000 per quality-adjusted life year (QALY) gained. When including all HPV-related outcomes, the ICER for vaccinating up to age 45 years ranged from $315,700 to $440,600 per QALY gained. Assumptions regarding cervical screening compliance, vaccine costs, and the natural history of noncervical HPV-related cancers had major impacts on the cost-effectiveness of the vaccination strategies. Key limitations of the study were related to uncertainties in the data used to inform the models, including the timing of vaccine impact on noncervical cancers and vaccine efficacy at older ages. CONCLUSIONS Our results from 2 independent models suggest that HPV vaccination for adult women and men aged 30 to 45 years is unlikely to represent good value for money in the US.
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Affiliation(s)
- Jane J. Kim
- Department of Health Policy and Management, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Kate T. Simms
- Cancer Research Division, Cancer Council New South Wales, Sydney, Australia
- School of Public Health, University of Sydney, Sydney, Australia
| | - James Killen
- Cancer Research Division, Cancer Council New South Wales, Sydney, Australia
| | - Megan A. Smith
- Cancer Research Division, Cancer Council New South Wales, Sydney, Australia
- School of Public Health, University of Sydney, Sydney, Australia
| | - Emily A. Burger
- Department of Health Policy and Management, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Stephen Sy
- Department of Health Policy and Management, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Catherine Regan
- Department of Health Policy and Management, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Karen Canfell
- Cancer Research Division, Cancer Council New South Wales, Sydney, Australia
- School of Public Health, University of Sydney, Sydney, Australia
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Terry TL, Givens BE, Adamcakova-Dodd A, Thorne PS, Rodgers VGJ, Salem AK. Encapsulating Polyethyleneimine-DNA Nanoplexes into PEGylated Biodegradable Microparticles Increases Transgene Expression In Vitro and Reduces Inflammatory Responses In Vivo. AAPS PharmSciTech 2021; 22:69. [PMID: 33565009 PMCID: PMC7872112 DOI: 10.1208/s12249-021-01932-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 01/12/2021] [Indexed: 11/30/2022] Open
Abstract
Encapsulating genetic material into biocompatible polymeric microparticles is a means to improving gene transfection while simultaneously decreasing the tendency for inflammatory responses; and can be advantageous in terms of delivering material directly to the lungs via aerosolization for applications such as vaccinations. In this study, we investigated the advantages of using polymeric microparticles carrying the luciferase reporter gene in increasing transfection efficiency in the readily transfectable HEK293 cell line and the difficult to transfect RAW264.7 cell line. The results indicated that there was a limit to the ratio of nitrogen in polyethylenimine (PEI) to phosphate in DNA (N/P ratio) beyond which further increases in transgene expression no longer, or only marginally, occurred. Microparticles encapsulating PEI:DNA nanoplexes induced cellular toxicity in a dose-dependent manner. PEGylation increased transgene expression, likely related to enhanced degradation of particles. Furthermore, intra-tracheal instillation in rats allowed us to investigate the inflammatory response in the lung as a function of PEGylation, porosity, and size. Porosity did not influence cell counts in bronchoalveolar lavage fluid in the absence of PEG, but in particles containing PEG, non-porous particles recruited fewer inflammatory cells than their porous counterparts. Finally, both 1 μm and 10 μm porous PLA-PEG particles recruited more neutrophils than 4 μm particles. Thus, we have shown that PEGylation and lack of porosity are advantageous for faster release of genetic cargo from microparticles and a reduced inflammatory response, respectively.
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The Use of Nanobiotechnology in Immunology and Vaccination. Vaccines (Basel) 2021; 9:vaccines9020074. [PMID: 33494441 PMCID: PMC7910821 DOI: 10.3390/vaccines9020074] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/12/2021] [Accepted: 01/20/2021] [Indexed: 01/07/2023] Open
Abstract
Nanotechnology uses the unique properties of nanostructures with a size of 1 to 200 nanometers. Different nanoparticles have shown great promise for the production of new vaccines and drugs. Nanostructures can be used to deliver immunological compounds more effectively than microstructures to target sites. Different nanostructures can be applied to form a new generation of vaccines, adjuvants, and immune system drugs. The goal of nanotechnology is to better respond to a wide range of infectious and non-infectious diseases.
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20
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Waters AV, Merrell LK, Thompson EL. Monogamy as a Barrier to Human Papillomavirus Catch-Up Vaccination. J Womens Health (Larchmt) 2021; 30:705-712. [PMID: 33416434 DOI: 10.1089/jwh.2020.8724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection (STI) in the United States. Although a vaccine to prevent HPV infection exists, only 53.7% of females 13-17 years of age were up-to-date on the HPV vaccination series in 2018. There is a catch-up period of vaccination for females 18-26 years of age that shows consistent underparticipation. A potential barrier to vaccination is relationship status, as long-term relationships may negatively impact HPV risk perception. This study examined monogamy as a risk factor for nonvaccination and explored how risk perception may influence this association. Materials and Methods: An electronic survey was distributed to females 18-26 years of age who attended a large public university in the mid-Atlantic region (n = 629). Multivariable and descriptive statistics were estimated using SAS 9.4 to explore the likelihood of vaccination during the catch-up period by relationship status. Results: Most participants had received the HPV vaccine, a small proportion of whom received it during the catch-up period. After adjusting for confounders, women who were in monogamous relationships were significantly less likely to have participated in HPV catch-up vaccination compared to women who were single and dating (adjusted odds ratio: 0.36, 95% confidence interval: 0.15, 0.87). Women in monogamous relationships had a lower average sexually transmitted disease (STD) risk perception compared to women who were single and dating (p < 0.0001). Conclusions: A decreased risk perception may present a barrier to participating in catch-up vaccination for monogamous women. Practitioners and the public health community should focus on communicating HPV risk to women in monogamous relationships, especially given the recently expanded age range for HPV vaccination.
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Affiliation(s)
- Ansley V Waters
- Department of Health Sciences, College of Health and Behavioral Studies, James Madison University, Harrisonburg, Virginia, USA
| | - Laura K Merrell
- Department of Health Sciences, College of Health and Behavioral Studies, James Madison University, Harrisonburg, Virginia, USA
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Soper BC, Nygård M, Abdulla G, Meng R, Nygård JF. A hidden Markov model for population-level cervical cancer screening data. Stat Med 2020; 39:3569-3590. [PMID: 32854166 DOI: 10.1002/sim.8681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/02/2020] [Accepted: 06/11/2020] [Indexed: 12/19/2022]
Abstract
The Cancer Registry of Norway has been administrating a national cervical cancer screening program since 1992 by coordinating triennial cytology exam screenings for the female population between 25 and 69 years of age. Up to 80% of cancers are prevented through mass screening, but this comes at the expense of considerable screening activity and leads to overtreatment of clinically asymptomatic precancers. In this article, we present a continuous-time, time-inhomogeneous hidden Markov model which was developed to understand the screening process and cervical cancer carcinogenesis in detail. By leveraging 1.7 million individual's multivariate time-series of medical exams performed over a 25-year period, we simultaneously estimate all model parameters. We show that an age-dependent model reflects the Norwegian screening program by comparing empirical survival curves from observed registry data and data simulated from the proposed model. The model can be generalized to include more detailed individual-level covariates as well as new types of screening exams. By utilizing individual screening histories and covariate data, the proposed model shows potential for improving strategies for cancer screening programs by personalizing recommended screening intervals.
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Affiliation(s)
- Braden C Soper
- Computing Directorate, Lawrence Livermore National Laboratory, Livermore, California, USA
| | - Mari Nygård
- Research Department, Cancer Registry of Norway, Oslo, Norway
| | - Ghaleb Abdulla
- Computing Directorate, Lawrence Livermore National Laboratory, Livermore, California, USA
| | - Rui Meng
- Department of Statistics, University of California, Santa Cruz, California, USA
| | - Jan F Nygård
- Registry Informatics Department, Cancer Registry of Norway, Oslo, Norway
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Liverani CA, Di Giuseppe J, Giannella L, Delli Carpini G, Ciavattini A. Cervical Cancer Screening Guidelines in the Postvaccination Era: Review of the Literature. JOURNAL OF ONCOLOGY 2020; 2020:8887672. [PMID: 33204265 PMCID: PMC7661145 DOI: 10.1155/2020/8887672] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/09/2020] [Accepted: 10/24/2020] [Indexed: 12/15/2022]
Abstract
Cervical cancer is relatively rare in high-income countries, where organized screening programs are in place, as well as opportunistic ones. As the human papillomavirus (HPV) vaccination rates increase, the prevalence of cervical precancers and cancers is going to decrease rapidly very soon, even if, in the most optimistic scenario, it is unlikely that optimal vaccination coverage will be achieved. Then, the optimal screening paradigm for cervical cancer prevention in the postvaccination era is still debated. Screening guidelines are being developed with the aim of reducing the number of tests a woman needs during her lifetime, in order to receive the maximum benefit from screening, while decreasing potential harms that may result with the use of a screening strategy (overdiagnosis, overtreatment, anxiety, and costs). With this purpose in mind, new management guidelines for cervical cancer screening abnormalities are recommendations based on risks, not on results. This review aims to summarize the process that led to the introduction of the HPV DNA test in screening programs and the different screening strategies. Moreover, it aims to introduce the new risk-based guidelines for the future, where full HPV genotyping can resize the risk on the basis of specific high-risk genotypes. In the same way, the data regarding HPV vaccination could be introduced as soon as women vaccinated with the nonavalent vaccine reach the screening age, with the recommendation of a prolonged screening interval.
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Affiliation(s)
| | - Jacopo Di Giuseppe
- Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona 60100, Italy
| | - Luca Giannella
- Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona 60100, Italy
| | - Giovanni Delli Carpini
- Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona 60100, Italy
| | - Andrea Ciavattini
- Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona 60100, Italy
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Asamoah FA, Yarney J, Scott A, Vanderpuye V, Yuan Z, Fernandez DC, Montejo ME, Agyeman M, Boateng SN, Anarfi K, Aidoo C, Shahzad MM, Chern JY, Chon HS, Wenham RM, Yamoah K, Ahmed KA. Comparison of Definitive Cervical Cancer Management With Chemotherapy and Radiation Between Two Centers With Variable Resources and Opportunities for Improved Treatment. JCO Glob Oncol 2020; 6:1510-1518. [PMID: 33021855 PMCID: PMC7605379 DOI: 10.1200/go.20.00303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Cervical cancer remains a major health challenge in low- to middle-income countries. We present the experiences of two centers practicing in variable resource environments to determine predictors of improved radiochemotherapy treatment. METHODS AND MATERIALS This comparative review describes cervical cancer presentation and treatment with concurrent chemoradiotherapy with high-dose-rate brachytherapy between 2014 and 2017 at the National Radiotherapy Oncology and Nuclear Medicine Center (NRONMC) in Korle-Bu Teaching Hospital, Accra, Ghana, and Moffitt Cancer Center (MCC), Tampa, FL. RESULTS Median follow-up for this study was 16.9 months. NRONMC patients presented with predominantly stage III disease (42% v 16%; P = .002). MCC patients received para-aortic node irradiation (16%) and interstitial brachytherapy implants (19%). Median treatment duration was longer for NRONMC patients compared with MCC patients (59 v 52 days; P < .0001), and treatment duration ≥ 55 days predicted worse survival on multivariable analysis (MVA; P = .02). Stage ≥ III disease predicted poorer local control on MVA. There was a difference in local control among patients with stage III disease (58% v 91%; P = .03) but not in survival between MCC and NRONMC. No significant difference in local control was observed for stage IB, IIA, and IIB disease. CONCLUSION Although there were significant differences in disease presentation between the two centers, treatment outcomes were similar for patients with early-stage disease. Longer treatment duration and stage ≥ III disease predicted poor outcomes.
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Affiliation(s)
- Francis Adumata Asamoah
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.,National Radiotherapy Oncology and Nuclear Medicine Center of the Korle-Bu Teaching Hospital, Accra, Ghana
| | - Joel Yarney
- National Radiotherapy Oncology and Nuclear Medicine Center of the Korle-Bu Teaching Hospital, Accra, Ghana
| | - Aba Scott
- National Radiotherapy Oncology and Nuclear Medicine Center of the Korle-Bu Teaching Hospital, Accra, Ghana
| | - Verna Vanderpuye
- National Radiotherapy Oncology and Nuclear Medicine Center of the Korle-Bu Teaching Hospital, Accra, Ghana
| | - Zhigang Yuan
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Daniel C Fernandez
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Michael E Montejo
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Mervin Agyeman
- National Radiotherapy Oncology and Nuclear Medicine Center of the Korle-Bu Teaching Hospital, Accra, Ghana
| | - Samuel Ntiamoah Boateng
- National Radiotherapy Oncology and Nuclear Medicine Center of the Korle-Bu Teaching Hospital, Accra, Ghana
| | - Kwabena Anarfi
- National Radiotherapy Oncology and Nuclear Medicine Center of the Korle-Bu Teaching Hospital, Accra, Ghana
| | - Charles Aidoo
- National Radiotherapy Oncology and Nuclear Medicine Center of the Korle-Bu Teaching Hospital, Accra, Ghana
| | - Mian M Shahzad
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Jing-Yi Chern
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Hye-Sook Chon
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Robert M Wenham
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Kosj Yamoah
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Kamran A Ahmed
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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York JM, Klosky JL, Chen Y, Connelly JA, Wasilewski-Masker K, Giuliano AR, Robison LL, Wong FL, Hudson MM, Bhatia S, Landier W. Patient-Level Factors Associated With Lack of Health Care Provider Recommendation for the Human Papillomavirus Vaccine Among Young Cancer Survivors. J Clin Oncol 2020; 38:2892-2901. [PMID: 32552278 DOI: 10.1200/jco.19.02026] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Young cancer survivors are at increased risk for morbidities related to infection with the human papillomavirus (HPV), yet their HPV vaccine initiation rates remain low. Patient-/parent-reported lack of health care provider recommendation for HPV vaccination is strongly associated with vaccine noninitiation. We aimed to identify patient-level factors associated with survivor-/parent-reported lack of provider recommendation for HPV vaccination among young cancer survivors. METHODS Cancer survivors ages 9-26 years and 1-5 years off therapy completed a cross-sectional survey (parent-completed for survivors 9-17 years of age). Lack of health care provider HPV vaccine recommendation was the outcome of interest in a multivariable logistic regression model that included relevant patient-level sociodemographic, clinical, and vaccine-related variables. RESULTS Of 955 survivors, 54% were male, 66% were non-Hispanic White, and 36% had leukemia. At survey participation, survivors were an average age (± standard deviation) of 16.3 ± 4.7 years and 32.8 ± 14.7 months off therapy. Lack of provider HPV vaccine recommendation was reported by 73% (95% CI, 70% to 75%) of survivors. For the entire cohort, patient-level factors associated with lack of reported provider recommendation included perceived lack of insurance coverage for the HPV vaccine (odds ratio [OR], 4.0; 95% CI, 2.7 to 5.9; P < .001), male sex (OR, 2.8; 95% CI, 1.9 to 4.0; P < .001), and decreased parent-survivor communication regarding HPV vaccination (OR, 1.7 per unit decrease in score; 95% CI, 1.3 to 2.2; P < .001). In the sex- and age-stratified models, perceived lack of insurance coverage (all models) and male sex (age-stratified models) were also significantly associated with lack of reported provider recommendation. CONCLUSION We identified factors characterizing survivors at risk for not reporting receipt of a health care provider HPV vaccine recommendation. Future research is needed to develop interventions that facilitate effective provider recommendations for HPV vaccination among all young cancer survivors.
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Affiliation(s)
| | - James L Klosky
- Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA
| | - Yanjun Chen
- University of Alabama at Birmingham, Birmingham, AL
| | | | | | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center, Tampa, FL
| | | | | | | | - Smita Bhatia
- University of Alabama at Birmingham, Birmingham, AL
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Saslow D, Andrews KS, Manassaram-Baptiste D, Smith RA, Fontham ETH. Human papillomavirus vaccination 2020 guideline update: American Cancer Society guideline adaptation. CA Cancer J Clin 2020; 70:274-280. [PMID: 32639044 DOI: 10.3322/caac.21616] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/19/2020] [Indexed: 01/12/2023] Open
Abstract
The American Cancer Society (ACS) presents an adaptation of the current Advisory Committee on Immunization Practices recommendations for human papillomavirus (HPV) vaccination. The ACS recommends routine HPV vaccination between ages 9 and 12 years to achieve higher on-time vaccination rates, which will lead to increased numbers of cancers prevented. Health care providers are encouraged to start offering the HPV vaccine series at age 9 or 10 years. Catch-up HPV vaccination is recommended for all persons through age 26 years who are not adequately vaccinated. Providers should inform individuals aged 22 to 26 years who have not been previously vaccinated or who have not completed the series that vaccination at older ages is less effective in lowering cancer risk. Catch-up HPV vaccination is not recommended for adults aged older than 26 years. The ACS does not endorse the 2019 Advisory Committee on Immunization Practices recommendation for shared clinical decision making for some adults aged 27 through 45 years who are not adequately vaccinated because of the low effectiveness and low cancer prevention potential of vaccination in this age group, the burden of decision making on patients and clinicians, and the lack of sufficient guidance on the selection of individuals who might benefit.
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Affiliation(s)
- Debbie Saslow
- Human Papillomavirus and Gynecologic Cancers, American Cancer Society, Atlanta, Georgia
| | - Kimberly S Andrews
- Guideline Development Process, American Cancer Society, Atlanta, Georgia
| | | | - Robert A Smith
- Cancer Screening, American Cancer Society, Atlanta, Georgia
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26
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Savoy M. What's New in Vaccine Science. Prim Care 2020; 47:517-528. [PMID: 32718447 DOI: 10.1016/j.pop.2020.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Today vaccines can provide immunity against and treatment of a growing number of diseases including noninfectious conditions. Vaccine science continues to evolve newer and safer ways to deliver prevention and treatment of infectious and noninfectious diseases. This includes new adjuvants to enhance immunogenicity; delivery systems to reduce pain and improve acceptability; a wider range of uses including preventing emerging infectious diseases, such as Zika virus and Ebola, treatment of chronic diseases, such as cancer, and autoimmune disorders; and repurposing of existing vaccines, such as bacillus Calmette-Guérin for novel therapies.
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Affiliation(s)
- Margot Savoy
- Family & Community Medicine, Temple Faculty Practice, Lewis Katz School of Medicine at Temple University, 1316 West Ontario Street, Room 310, Philadelphia, PA 19140, USA.
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Scull TM, Keefe EM, Kafka JM, Malik CV, Kupersmidt JB. The understudied half of undergraduates: Risky sexual behaviors among community college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:302-312. [PMID: 30676913 PMCID: PMC6656636 DOI: 10.1080/07448481.2018.1549554] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 09/06/2018] [Accepted: 11/12/2018] [Indexed: 06/09/2023]
Abstract
Objective: This study examines the prevalence and risk factors associated with risky sexual behaviors in community college students. Participants: A diverse sample of 18-19-year-old community college students (N = 264). Methods: Baseline data from an online prevention program administered in 2015. Results: Community college students in this sample disproportionately experienced sexual assault and were unlikely to test for STIs. Higher intentions to engage in risky sexual behaviors were associated with gender and sexual experience, but also with having lower intentions to communicate with a sexual partner about pregnancy and STIs, and having higher gender norm endorsement. Conclusions: Older adolescents attending community colleges may be at high risk for poor sexual health outcomes, and appropriate theory-based education should be tailored to meet the needs of these underserved students.
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Affiliation(s)
- Tracy M Scull
- Innovation Research & Training, Durham, North Carolina, USA
| | - Elyse M Keefe
- Innovation Research & Training, Durham, North Carolina, USA
| | - Julie M Kafka
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
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Hubbard D, Shrestha S, Levitan EB, Yun H. Human Papillomavirus Vaccination Schedule: Adherence Among Commercially Insured Adolescents and Young Adults in the United States, 2011–2017. Am J Public Health 2020; 110:385-390. [DOI: 10.2105/ajph.2019.305485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To determine rates of human papillomavirus (HPV) vaccine adherence to the 2011 and 2016 Advisory Committee for Immunization Practices (ACIP) recommendations in the United States. Methods. We conducted a retrospective cohort study by using the 2011 to 2017 Marketscan data for beneficiaries aged 9 to 26 years who had at least 1 claim for HPV vaccination between January 1, 2011, and January 1, 2017. According to the 2011 ACIP recommendation, adherence is defined as 30 to 90 days between the first and second vaccination and 168 to 212 days between the first and third vaccination. According to the 2016 recommendation, preadolescents are classified as adherent if they had 2 claims of vaccination within 168 to 212 days. We calculated proportions of completion and adherence by recommendation. Results. Among patients classified under the 2011 ACIP recommendation (n = 2 164 096), 8.3% completed all 3 doses of the vaccine series. Of those who completed, 69.6% were considered adherent to the recommended schedule. Completion and adherence increased to 9.6% and 70.8%, respectively, among patients who were classified under the 2016 ACIP recommendation. Conclusions. Simpler recommendations lead to better adherence to the HPV vaccination schedule.
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Affiliation(s)
- Demetria Hubbard
- All authors are affiliated with the Department of Epidemiology, University of Alabama at Birmingham
| | - Sadeep Shrestha
- All authors are affiliated with the Department of Epidemiology, University of Alabama at Birmingham
| | - Emily B. Levitan
- All authors are affiliated with the Department of Epidemiology, University of Alabama at Birmingham
| | - Huifeng Yun
- All authors are affiliated with the Department of Epidemiology, University of Alabama at Birmingham
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Soudeyns C, Speybroeck N, Brisson M, Mossong J, Latsuzbaia A. HPV vaccination and sexual behaviour in healthcare seeking young women in Luxembourg. PeerJ 2020; 8:e8516. [PMID: 32095350 PMCID: PMC7017793 DOI: 10.7717/peerj.8516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/05/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) worldwide. Despite recommendations for HPV vaccination of young women from health authorities, parental concerns were raised whether vaccination could induce unsafe sexual behaviour in young women. Therefore, the primary aim of this study was to investigate if HPV vaccination in healthcare seeking adult women in Luxembourg was associated with unsafe sexual behaviour. Methods Seven hundred twenty-nine women (mean age = 22.5; range 18-43 years) were recruited either at Luxembourg family planning centres or at private gynaecology practices. All participants completed a questionnaire on vaccination status and sexual behaviour. Poisson and logistic regressions were used to study the association between sexual behaviour and vaccination status (N = 538). Both models were restricted to women younger than 26 years, since the first cohort being vaccinated would be 25 years old at the time of sampling. Assortativity of sexual mixing by age was also assessed for further transmission modelling for women <30 years reporting age of last/current sexual partner (N = 649). Women older than 29 years were excluded from the assortativity analysis due to restricted sample size. Results In total, 386/538 (71.8%) of participants reported receiving HPV vaccine. Vaccination uptake significantly varied by nationality and was higher in Portuguese 112/142 (78.9%) and in Luxembourgish 224/313(71.6%) residents, and lower in residents of other nationalities 50/83 (60.2%) (p = 0.011). HPV vaccination was not associated with unsafe sexual behaviour such as shorter relationship duration with current or last sexual partner (odds ratio (OR) = 1.05, 95% CI [0.94-1.16]), younger age of sexual debut (OR = 1.00, 95% CI [0.88-1.14]), increased number of lifetime sexual partners (OR = 0.95, 95% CI [0.87-1.03), higher age difference with sexual partner (OR = 1.01, 95% CI [0.95-1.08]), condom use (OR = 0.97, 95% CI [0.60-1.56]), nor with other factors like smoking (OR = 0.73, 95% CI [0.47-1.15]) and nationality. HPV vaccination was only associated with younger age (OR = 0.84, 95% CI [0.75-0.94]). Relationship duration, age of sexual debut, age difference with sexual partner, smoking, age and non-Portuguese foreign nationality were predictors of number of lifetime sexual partners. Assortativity analysis revealed that young women chose sexual partners who were 2.3 years older on average. Conclusions Our study found no association between unsafe sexual behaviour and HPV vaccination.
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Affiliation(s)
- Camille Soudeyns
- Public Health Faculty, Université Catholique de Louvain, Brussels, Belgium
| | - Niko Speybroeck
- Public Health Faculty, Université Catholique de Louvain, Brussels, Belgium
| | - Marc Brisson
- Department of Social and Preventive Medicine, Université Laval, Quebec, Canada
| | - Joël Mossong
- Epidemiology and Microbial Genomics, Laboratoire National de Santé, Dudelange, Luxembourg
| | - Ardashel Latsuzbaia
- Epidemiology and Microbial Genomics, Laboratoire National de Santé, Dudelange, Luxembourg
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Adams SA, Haynes VE, Brandt HM, Choi SK, Young V, Eberth JM, Hébert JR, Friedman DB. Cervical cancer screening behaviors and proximity to federally qualified health centers in South Carolina. Cancer Epidemiol 2020; 65:101681. [PMID: 32035294 DOI: 10.1016/j.canep.2020.101681] [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: 08/08/2019] [Revised: 12/18/2019] [Accepted: 01/28/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Lack of participation in cervical cancer screening in underserved populations has been attributed to access to care, particularly among women in rural areas. Federally Qualified Health Centers (FQHCs) were created to address this need in medically underserved populations. This study observed proximity to three health centers in relation to cervical cancer screening rates in South Carolina. METHODS Data were obtained from FQHC patient visits (from 3 centers) between 2007-2010 and were limited to women eligible for cervical cancer screening (n = 24,393). ArcGIS was used to geocode patients addresses and FQHC locations, and distance was calculated. Modified Poisson regression was used to estimate relative risk of obtaining cervical cancer screening within one yearor ever, stratified by residential area. RESULTS Findings differed markedly by center and urban/rural status. At two health clinics, rural residents living the furthest away from the clinic (∼9 miles difference between quartile 4 and quartile 1) were more likely to be ever screened (RRs = 1.05 and 1.03, p-values < 0.05), while urban residents living the furthest away were less likely to be ever screened (RR = 0.85, p-value < 0.05). At the third center, only urban residents living the furthest away were more likely to be ever screened (RR = 1.02, p-value < 0.05). CONCLUSIONS Increased travel distance significantly increased the likelihood of cervical cancer screening at two FQHC sites while significantly decreasing the likelihood of screening at the 3rd site. These findings underscore the importance of contextual and environmental factors that impact use of cervical cancer screening services.
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Affiliation(s)
- Swann Arp Adams
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, United States; College of Nursing, University of South Carolina, 1601 Greene Street Columbia, SC, 29208, United States; Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street Columbia, SC, 29208, United States.
| | - Venice E Haynes
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, United States; Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street Columbia, SC, 29208, United States.
| | - Heather M Brandt
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, United States; Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street Columbia, SC, 29208, United States.
| | - Seul Ki Choi
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, United States; Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street Columbia, SC, 29208, United States; Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, South Korea.
| | - Vicki Young
- South Carolina Primary Care Association, 3 Technology Circle Columbia, SC, 29203, United States.
| | - Jan M Eberth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, United States; Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street Columbia, SC, 29208, United States.
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, United States; Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street Columbia, SC, 29208, United States.
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, United States; Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street Columbia, SC, 29208, United States.
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Liu Y, Quan Y, Xu C, Huang Y, Li D, Qing Q, Sun C, Zhou H. HPV infection screening using surface plasmon resonance in women from Kunming (Southwest China). Bosn J Basic Med Sci 2020; 20:125-130. [PMID: 31509732 PMCID: PMC7029204 DOI: 10.17305/bjbms.2019.4352] [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: 07/11/2019] [Accepted: 09/10/2019] [Indexed: 11/17/2022] Open
Abstract
No study examined the frequency of human papillomavirus (HPV) genotypes by surface plasmon resonance (SPR) in Southwest China. This was a cross-sectional survey (The Second Affiliated Hospital of Kunming Medical University, 10/2010 to 12/2011) in 150 patients who were hospitalized or volunteered for cervical cancer (CC) screening. A HPV typing kit was used to detect 24 types of HPV by the SPR technique. The HPV-positive rate was 34.8% in women with normal cytology and 92.9% in women with CC. The frequency of HPV16 increased from 9.4% for women with normal cytology to 28.9% for cervical intraepithelial neoplasia (CIN)1, 41.4% for CIN2, 54.1% for CIN3, and 71.4% for CC (p < 0.001). The frequency of HPV18 increased from 0% for women with normal cytology to 2.6% for CIN1, 3.4% for CIN2, 5.4% for CIN3, and 21.4% for CC (p = 0.03). HPV40 was only found in one patient with CC (p = 0.04). There was no relation between HPV genotype and women’s age. In Kunming (Southwest China), the frequency of HPV infection was 74.0% among women who underwent CC screening. HPV16 and HPV18 were the two most frequent genotypes. SPR could be of value for the screening of HPV infection.
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Affiliation(s)
- Yang Liu
- Department of Reproductive, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China
| | - Yue Quan
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen Fujian, China
| | - Changjun Xu
- Department of Reproductive, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China
| | - Yajuan Huang
- Department of Reproductive, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China
| | - Daizhu Li
- Department of Reproductive, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China
| | - Qing Qing
- Department of Reproductive, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China
| | - Chunyi Sun
- Department of Reproductive, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China
| | - Honglin Zhou
- Department of Reproductive, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China.
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Abdel-Rahman O. Prognostic value of HPV status among patients with hypopharyngeal carcinoma: a population-based study. Clin Transl Oncol 2020; 22:1645-1650. [PMID: 31939101 DOI: 10.1007/s12094-020-02289-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 01/02/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To clarify the prognostic role of human papilloma virus (HPV) status among patients with hypopharyngeal carcinoma. METHODS Surveillance, Epidemiology and End Results (SEER) HPV head and neck cancer database has been accessed and cases with hypopharyngeal squamous cell carcinoma with known HPV status were retrieved. Kaplan-Meier survival estimates were used to evaluate the impact of HPV status on overall survival outcomes of included patients and multivariable cox regression analysis was used to assess the impact of HPV status on overall and head and neck cancer-specific survival. RESULTS A total of 1157 patients' records with hypopharyngeal carcinoma were included in the current analysis. Using Kaplan-Meier survival estimates, patients with HPV positive status seem to have better overall survival compared to patients with HPV negative status (P < 0.01). When stratified by stage, patients with HPV positive regional and distant disease have better overall survival compared to patients with HPV negative regional and distant disease (P < 0.01 for both categories). The same observation cannot be confirmed for patients with localized disease (P = 0.15). Using multivariable Cox regression analysis, HPV positive status seems to be associated with better overall survival (HR for HPV negative versus HPV positive status: 1.76; 95% CI 1.39-2.24; P < 0.01) and cancer-specific survival (HR for HPV negative versus HPV positive status: 1.54; 95% CI 1.12-2.11; P < 0.01). CONCLUSIONS Patients with HPV positive hypopharyngeal carcinoma seem to have better overall and cancer-specific survival compared to patients with HPV negative hypopharyngeal carcinoma.
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Affiliation(s)
- O Abdel-Rahman
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB, T6G 1Z2, Canada.
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Chen H, Yang H, Fan D, Deng J. The Anticancer Activity and Mechanisms of Ginsenosides: An Updated Review. EFOOD 2020. [DOI: 10.2991/efood.k.200512.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Jain P, Singh S, Jain M, Ralli M, Sen R. The expression of cyclooxygenase-2 in carcinoma of uterine cervix. CLINICAL CANCER INVESTIGATION JOURNAL 2020. [DOI: 10.4103/ccij.ccij_118_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cannovo N, Cingolani M, Guarino R, Fedeli P. Regulation of Biobanks in Italy. Front Pediatr 2020; 8:415. [PMID: 32984196 PMCID: PMC7492532 DOI: 10.3389/fped.2020.00415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/16/2020] [Indexed: 12/13/2022] Open
Abstract
In Italy, a biobank is "a non-profit organization that must be officially recognized by the appropriate healthcare authority in the member states and must guarantee the treatment, distribution and conservation of biological material according to standards of quality and professionalism," but must not conserve material already regulated by specific laws, as is the case for organs for transplants, blood for transfusions, as well as embryos and gametes for medically assisted reproduction. The concept of biobank includes not only biological samples, but also the related database of clinical and personal information, from which the subject's lifestyle can be deduced. Unfortunately, at the moment, Italian law does not offer specific itineraries for achieving this legal status.
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Affiliation(s)
| | - Mariano Cingolani
- Department of Law, Institute of Legal Medicine, University of Macerata, Macerata, Italy
| | | | - Piergiorgio Fedeli
- Legal Medicine Section, School of Law, University of Camerino, Camerino, Italy
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Christodoulou A, Ajzajian J, Su D, Wang H, Roupa Z, Farazi PA. Awareness of human papilloma virus and cervical cancer prevention among Cypriot female healthcare workers. Ecancermedicalscience 2019; 13:978. [PMID: 31921349 PMCID: PMC6946423 DOI: 10.3332/ecancer.2019.978] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Cervical cancer incidence varies around the world with the highest rates in Eastern Africa and the lowest rates in Western Asia. In Cyprus, a small Mediterranean island, cervical cancer incidence was 6.4 per 100,000 in 2013. HPV is an established risk factor for cervical cancer with HPV-16 and HPV-18 being the most common carcinogenic strains. Cervical cancer is preventable through primary (HPV vaccination) and secondary (Pap and HPV tests) prevention. These prevention methods should be promoted, however, in order to design a cancer prevention programme and the awareness and characteristics of populations should be investigated so that prevention programmes can be targeted specifically to them. METHODS In this work, we sought to investigate awareness of HPV and cervical cancer prevention among female healthcare workers in Cyprus. To achieve this, we conducted a 60-item survey among 200 healthcare professionals in randomly selected hospitals in two different cities within Cyprus. RESULTS Our results revealed that nearly 10% of our participants reported not ever having had a Pap test. 88.5% of the healthcare workers knew about HPV and 86.5% reported that HPV is transmitted through sexual intercourse. 83.5% of the participants were willing to vaccinate themselves for cervical cancer prevention. CONCLUSION Even though awareness and vaccination acceptance were relatively high, they are still not optimal for healthcare professionals who play an essential role in health promotion. We suggest the design of educational programmes to target this population and improve their knowledge so that they can promote cervical cancer prevention in their health practice.
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Affiliation(s)
- Andria Christodoulou
- University of Nicosia, 46 Makedonitissas Avenue, Nicosia 2417, Cyprus
- Cyprus Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3036, Cyprus
| | - Jirayr Ajzajian
- University of Nicosia, 46 Makedonitissas Avenue, Nicosia 2417, Cyprus
| | - Dejun Su
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Hongmei Wang
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Zoe Roupa
- University of Nicosia, 46 Makedonitissas Avenue, Nicosia 2417, Cyprus
| | - Paraskevi A Farazi
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE 68198, USA
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Agénor M, Murchison GR, Chen JT, Bowen DJ, Rosenthal MB, Haneuse S, Austin SB. Impact of the Affordable Care Act on human papillomavirus vaccination initiation among lesbian, bisexual, and heterosexual U.S. women. Health Serv Res 2019; 55:18-25. [PMID: 31709542 DOI: 10.1111/1475-6773.13231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To examine the effect of the 2010 Affordable Care Act (ACA) extended dependent coverage and no cost-sharing provisions on human papillomavirus (HPV) vaccination in relation to sexual orientation identity among U.S. women. DATA SOURCES 2006-2010 and 2011-2015 National Survey of Family Growth. STUDY DESIGN We used an interrupted time series design and multivariable Poisson regression to assess differences in HPV vaccination initiation before (2007-2010) and after (2011-2015) the 2010 ACA provisions among heterosexual, bisexual, and lesbian U.S. women aged 15-25 years (N = 7033), adjusting for temporal trends and demographic factors. DATA COLLECTION Computer-assisted personal interview and audio computer-assisted self-interview questionnaires. PRINCIPAL FINDINGS The adjusted prevalence of HPV vaccination initiation was significantly higher among lesbian and bisexual women after compared to before the 2010 ACA-at 19.1 (95% confidence interval [CI]: 5.4, 32.9) and 15.7 (95% CI: 4.4, 27.1) percentage points in 2015 compared to 2007-2010, respectively. We observed no association between the 2010 ACA provisions and HPV vaccination initiation among heterosexual women after adjusting for temporal trends and demographic factors. CONCLUSIONS The 2010 ACA provisions may have improved HPV vaccination initiation among lesbian and bisexual women. Policies and programs that increase access to health insurance and provide HPV vaccines at no cost to patients may facilitate HPV vaccine uptake in these marginalized populations.
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Affiliation(s)
- Madina Agénor
- Department of Community Health, Tufts University, Medford, Massachusetts.,The Fenway Institute, Fenway Health, Boston, Massachusetts
| | - Gabriel R Murchison
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, Washington.,Department of Health Services, University of Washington School of Public Health, Seattle, Washington
| | - Meredith B Rosenthal
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sydney Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
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38
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Wheeler BS, Rositch AF, Poole C, Taylor SM, Smith JS. Patterns of incident genital human papillomavirus infection in women: A literature review and meta-analysis. Int J STD AIDS 2019; 30:1246-1256. [PMID: 31640474 DOI: 10.1177/0956462418824441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human papillomavirus (HPV) infection acquisition is a necessary step in the development of cervical cancer. No study has systematically quantified the rate of newly acquired HPV infections from the published literature and determined its relationship with age. We performed a systematic review and meta-analysis to describe incident HPV infections in women. Medline® and Thomson Reuters Web of Science via PubMed® databases were searched. A total of 46 of 5136 studies met inclusion criteria and contributed results. We conducted a meta-regression analysis of 13 studies, which reported incidence rate estimates on over 13 high-risk HPV types, to provide pooled stratum-specific incidence rates and rate ratios for key population and study characteristics among 8488 women. Studies with mean age < 30 years had relatively higher HPV incidence rates compared to studies with mean age ≥30 years: relative risk = 3.12; 95% CI: 1.41–6.93. HPV-16 was most frequently detected, followed by HPV-18: relative risk = 0.47; 95% CI: 0.33–0.67, and by HPV-58: relative risk = 0.45; 95% CI: 0.27–0.74. Younger age is a key predictor of genital HPV incidence in women. These data on the relative distribution of incident HPV infections will provide a baseline comparison for monitoring of changes in HPV incidence following the implementation of population-level HPV vaccination.
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Affiliation(s)
- Bradford S Wheeler
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | - Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,SALineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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Kundrod KA, Smith CA, Hunt B, Schwarz RA, Schmeler K, Richards-Kortum R. Advances in technologies for cervical cancer detection in low-resource settings. Expert Rev Mol Diagn 2019; 19:695-714. [PMID: 31368827 DOI: 10.1080/14737159.2019.1648213] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Introduction: Cervical cancer mortality rates remain high in low- and middle-income countries (LMICs) and other medically underserved areas due to challenges with implementation and sustainability of routine screening, accurate diagnosis, and early treatment of preinvasive lesions. Areas covered: In this review, we first discuss the standard of care for cervical cancer screening and diagnosis in high- and low-resource settings, biomarkers that correlate to cervical precancer and cancer, and needs for new tests. We review technologies for screening and diagnosis with a focus on tests that are already in use in LMICs or have the potential to be adapted for use in LMICs. Finally, we provide perspectives on the next five years of technology development for improved cervical cancer screening and diagnosis in LMICs. Expert opinion: Innovation toward improved molecular and imaging tests is needed to enable effective, affordable see-and-treat approaches to detect and treat cervical precancer in a single visit. Current molecular tests remain too complex and/or costly for widespread use. Especially with imaging tests, decision support may improve performance of new technologies.
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Affiliation(s)
| | - Chelsey A Smith
- Department of Bioengineering, Rice University , Houston , TX , USA
| | - Brady Hunt
- Department of Bioengineering, Rice University , Houston , TX , USA
| | | | - Kathleen Schmeler
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center , Houston , TX , USA
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Abstract
Through the implementation of systematic cervical cancer screening in the mid-20th century, the United States and other developed countries have seen death rates from cervical cancer decreased by ≥70%.The purpose of this article is to address several of the most controversial issues associated with cervical cancer screening recommendations in light of historical and evolving data. In this article, we will explore the controversies around the age at which to initiate and exit screening, human papilloma virus testing alone as a primary screening approach, and the impact of human papilloma virus vaccination on cervical cancer rates.
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41
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Islami F, Fedewa SA, Jemal A. Trends in cervical cancer incidence rates by age, race/ethnicity, histological subtype, and stage at diagnosis in the United States. Prev Med 2019; 123:316-323. [PMID: 31002830 DOI: 10.1016/j.ypmed.2019.04.010] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 04/01/2019] [Accepted: 04/14/2019] [Indexed: 11/28/2022]
Abstract
Recent trends of cervical cancer incidence by histology and age in the United States (U.S.) have not been reported. We examined contemporary trends in cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) incidence rates in the U.S. by age group, race/ethnicity, and stage at diagnosis after accounting for hysterectomy. Incidence data (1999-2015) were obtained from the U.S. Cancer Statistics Incidence Analytic Database. Hysterectomy prevalence was estimated using National Health Interview Survey data (2000-2015). Overall SCC incidence rates continued to decrease in all racial/ethnic groups except among non-Hispanic whites in whom rates stabilized in the 2010s, largely driven by stable trends in ages <50 years and a slower pace of decrease in ages 50-59 years. After a stable trend between 1999 and 2002, AC incidence rates among non-Hispanic whites rose during 2002-2015 (1.3% per year), mostly due to increases in ages 40-49 (4.4% annually since 2004) and 50-59 years (5.5% annually since 2011). Overall AC incidence rates during 1999-2015 decreased in blacks and Hispanics but were stable in Asian/Pacific Islanders; in all these race/ethnicities, rates were generally stable in ages <50 years but decreasing in older ages. Rates of distant stage cervical SCC and AC among non-Hispanic whites increased in several age groups but were generally stable in non-whites. Increasing or stabilized incidence trends for AC and attenuation of earlier declines for SCC in several subpopulations underscore the importance of intensifying efforts to reverse the increasing trends and further reduce the burden of cervical cancer in the U.S.
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Affiliation(s)
- Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States of America.
| | - Stacey A Fedewa
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States of America
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States of America
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42
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Moghtaderi A, Dor A. Immunization and Moral Hazard: The HPV Vaccine and Uptake of Cancer Screening. Med Care Res Rev 2019; 78:125-137. [PMID: 31096862 DOI: 10.1177/1077558719847887] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Immunization can lead to moral hazard by reducing the cost of risky behaviors and reducing preventive efforts. In this study, we examine the effect of HPV (human papillomavirus) vaccination on participation in the Pap test, which is a diagnostic screening test to detect HPV and non-HPV-related cancerous processes. The HPV vaccination is explicitly recommended for women up to age 26 years who were not previously vaccinated. Pap tests are strongly recommended for women between 21 and 65 years old even after having the HPV vaccine. To study the effect of HPV vaccination on Pap test uptake, we construct a fuzzy regression discontinuity design, centered on the vaccination threshold age. The results suggest that moral hazard was not the dominant effect. The estimates show that women who have been vaccinated, if anything, are actually more likely to have a Pap test, possibly due to increased awareness of its benefits at the time of vaccination.
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Affiliation(s)
| | - Avi Dor
- George Washington University, Washington, DC, USA
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43
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Smith RA, Andrews KS, Brooks D, Fedewa SA, Manassaram-Baptiste D, Saslow D, Wender RC. Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin 2019; 69:184-210. [PMID: 30875085 DOI: 10.3322/caac.21557] [Citation(s) in RCA: 355] [Impact Index Per Article: 71.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, the current American Cancer Society cancer screening guidelines are summarized, and the most current data from the National Health Interview Survey are provided on the utilization of cancer screening for men and women and on the adherence of men and women to multiple recommended screening tests.
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Affiliation(s)
- Robert A Smith
- Vice-President, Cancer Screening, and Director, Center for Quality Cancer Screening and Research, Cancer Control Department, American Cancer Society, Atlanta, GA
| | - Kimberly S Andrews
- Director, Guidelines Process, Cancer Control Department, American Cancer Society, Atlanta, GA
| | - Durado Brooks
- Vice President, Cancer Control Interventions, Cancer Control Department, American Cancer Society, Atlanta, GA
| | - Stacey A Fedewa
- Senior Principal Scientist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | | | - Debbie Saslow
- Senior Director, Human Papillomavirus-Related and Women's Cancers, Cancer Control Department, American Cancer Society, Atlanta, GA
| | - Richard C Wender
- Chief Cancer Control Officer, American Cancer Society, Atlanta, GA
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44
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Petousis-Harris H, Radcliff FJ. Exploitation of Neisseria meningitidis Group B OMV Vaccines Against N. gonorrhoeae to Inform the Development and Deployment of Effective Gonorrhea Vaccines. Front Immunol 2019; 10:683. [PMID: 31024540 PMCID: PMC6465565 DOI: 10.3389/fimmu.2019.00683] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 03/13/2019] [Indexed: 01/13/2023] Open
Abstract
Have potential clues to an effective gonorrhea vaccine been lurking in international disease surveillance data for decades? While no clinically effective vaccines against gonorrhea have been developed we present direct and indirect evidence that a vaccine is not only possible, but may already exist. Experience from Cuba, New Zealand, and Canada suggest that vaccines containing Group B Neisseria meningitides outer membrane vesicles (OMV) developed to control type-specific meningococcal disease may also prevent a significant proportion of gonorrhea. The mechanisms for this phenomenon have not yet been elucidated but we present some strategies for unraveling potential cross protective antigens and effector immune responses by exploiting stored sera from clinical trials and individuals primed with a meningococcal group B OMV vaccine (MeNZB). Elucidating these will contribute to the ongoing development of high efficacy vaccine options for gonorrhea. While the vaccine used in New Zealand, where the strongest empirical evidence has been gathered, is no longer available, the OMV has been included in the multi component recombinant meningococcal vaccine 4CMenB (Bexsero) which is now licensed and used in numerous countries. Several lines of evidence suggest it has the potential to affect gonorrhea prevalence. A vaccine to control gonorrhea does not need to be perfect and modeling supports that even a moderately efficacious vaccine could make a significant impact in disease prevalence. How might we use an off the shelf vaccine to reduce the burden of gonorrhea? What are some of the potential societal barriers in a world where vaccine hesitancy is growing? We summarize the evidence and consider some of the remaining questions.
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Affiliation(s)
- Helen Petousis-Harris
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Fiona J Radcliff
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
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Soozangar N, Sadeghi MR, Jeddi F, Samadi N, Hejazi MS, Azad M, Shirmohamadi M, Somi MH. Decreased expression of the Keap1 gene and its clinicopathological significance in gastric cancer: correlation with promoter DNA methylation. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03799-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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46
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Islam JY, Gruber JF, Kepka D, Kunwar M, Smith SB, Rothholz MC, Brewer NT, Smith JS. Pharmacist insights into adolescent human papillomavirus vaccination provision in the United States. Hum Vaccin Immunother 2019; 15:1839-1850. [PMID: 30550369 DOI: 10.1080/21645515.2018.1556077] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
HPV vaccination coverage in the United States (US) falls short of the Healthy People 2020 goal of 80% coverage among 13-15 year-old adolescents. Pharmacies are a promising alternative vaccine delivery site that may increase access to HPV vaccination. Our objective was to assess pharmacists' insights into HPV vaccination provision to adolescents. We recruited 40 licensed pharmacists in eight states with different pharmacy vaccination laws: Alabama, California, Indiana, Kentucky, Maine, Tennessee, Texas, and Washington. Eligible pharmacists either previously provided or were currently providing HPV, tetanus-diphtheria-pertussis, or meningococcal vaccines to adolescents aged 9-17 years. Pharmacists were administered a semi-structured survey to explore insights into HPV vaccination provision. Forty-five percent of surveyed pharmacies offered HPV vaccination to adolescents. Pharmacists' reported challenges to providing HPV vaccination were parental consent (28%), tracking and patient recall (17%), perceived stigma of vaccination (17%), and education about or promotion of vaccination (17%). Pharmacists offering HPV vaccination sent patient reminders for vaccines with multiple doses (89%) and utilized telephone reminders (72%). Pharmacists informed patients' primary care providers of HPV vaccination doses most commonly through fax (72%) and updating electronic medical records (22%). One-third of pharmacists reported vaccination provision using the state immunization information system (IIS). Seventy-five percent reported vaccination rates could be increased at their respective pharmacy. Pharmacies are underutilized, although highly accessible, for HPV vaccination in the US. National efforts should expand educational programs to improve public awareness of in-pharmacy HPV vaccination, and improve the utilization of state IIS for reporting immunization coverage of adolescents by pharmacists.
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Affiliation(s)
- Jessica Y Islam
- a Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Joann F Gruber
- a Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Deanna Kepka
- b College of Nursing & Huntsman Cancer Institute, University of Utah , Salt Lake City , UT , USA
| | - Manju Kunwar
- c Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Sara B Smith
- a Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | | | - Noel T Brewer
- e Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.,f UNC Lineberger Comprehensive Cancer Center, University of North Carolina , Chapel Hill , NC , USA
| | - Jennifer S Smith
- a Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.,f UNC Lineberger Comprehensive Cancer Center, University of North Carolina , Chapel Hill , NC , USA
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47
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Aldohaian AI, Alshammari SA, Arafah DM. Using the health belief model to assess beliefs and behaviors regarding cervical cancer screening among Saudi women: a cross-sectional observational study. BMC WOMENS HEALTH 2019; 19:6. [PMID: 30621680 PMCID: PMC6323726 DOI: 10.1186/s12905-018-0701-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 12/12/2018] [Indexed: 01/17/2023]
Abstract
Background Cervical cancer in Saudi Arabia is ranked as the third most frequent gynecological cancer among women. The Pap smear test is a screening test that can be used as a primary prevention tool for cervical cancer, and prophylactic vaccination against HPV is also considered to be a factor in decreasing the prevalence of the disease. This study aimed to assess women’s beliefs about cervical cancer and the Pap smear test. In addition, the relationship between cervical cancer and the social and demographic characteristics was also evaluated. Methods A descriptive cross-sectional study was performed among Saudi women living in Riyadh in 2018. Women were randomly selected, and the total sample size was 450. A predesigned self-administered questionnaire that included the Health Belief Model scale was used to collect data. Data were analyzed using SPSS 21.0. P values < 0.05 were considered as statistically significant in this study. Results Among the 450 participants, the Pap smear test uptake was 26% and the HPV vaccine uptake was less than 1%. A low education level and family history for cervical cancer were significantly associated with the belief of high susceptibility for developing cervical cancer (p < 0.05). The seriousness of the disease was recognized by 38%, and the benefit of screening was recognized by 82% of the participants. In addition, 27% of the participants perceived barriers to obtaining a Pap smear test. Conclusions This study showed a high level of perception regarding benefits and motivation, and a low incidence of perceived barriers among women regarding cervical cancer screening. However, these attitudinal aspects did not translate into practice, as reflected by the low uptake of the screening test. Our findings imply that concerted efforts are needed to promote cervical cancer screening programs in Saudi Arabia. In view of the planned implementation of Saudi vision 2030, which emphasizes on prevention, we recommend launching a national cervical cancer screening program, to be available and accessible to all women in primary health care centers and hospitals.
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Affiliation(s)
- Arwa I Aldohaian
- Department of Family & community medicine, College of Medicine, King Saud Medical University, Riyadh, Kingdom of Saudi Arabia.
| | - Sulaiman A Alshammari
- Department of Family & community medicine, College of Medicine, King Saud Medical University, Riyadh, Kingdom of Saudi Arabia
| | - Danyah M Arafah
- Department of Family & community medicine, College of Medicine, King Saud Medical University, Riyadh, Kingdom of Saudi Arabia
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48
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Xiao D, Liu D, Wen Z, Huang X, Zeng C, Zhou Z, Han Y, Ye X, Wu J, Wang Y, Guo C, Ou M, Huang S, Huang C, Wei X, Yang G, Jing C. Interaction Between Susceptibility Loci in MAVS and TRAF3 Genes, and High-risk HPV Infection on the Risk of Cervical Precancerous Lesions in Chinese Population. Cancer Prev Res (Phila) 2018; 12:57-66. [PMID: 30463990 DOI: 10.1158/1940-6207.capr-18-0177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/28/2018] [Accepted: 11/05/2018] [Indexed: 11/16/2022]
Abstract
Persistent high-risk HPV infection is considered as a major cause of cervical cancer. Nevertheless, only some infected individuals actually develop cervical cancer. The RIG-I pathway in innate immunity plays an important role in antivirus response. Here, we hypothesized that altered function of mitochondrial antiviral signaling protein (MAVS) and mitochondrial TNF receptor-associated factor 3(TRAF3), key molecules downstream of the viral sensors RIG-I, may impair their ability of clearing HPV and thereby influence the risk for cervical precancerous lesions. To investigate the effects of MAVS and TRAF3 polymorphisms on susceptibility to cervical precancerous lesions, 8 SNPs were analyzed in 164 cervical precancerous lesion cases and 428 controls. Gene-environment interactions were also calculated. We found that CA genotype of rs6052130 in MAVS gene were at 1.48 times higher risk of developing cervical precancerous lesion than individuals with CC genotype (CA vs. CC: ORadjusted = 1.48, 95% CI, 1.02-2.16). In addition, a significant synergetic interaction between high-risk HPV infection and rs6052130 was found on an additive scale. A significantly decreased risk of cervical precancerous lesions for the TC genotype of rs12435483 in the TRAF3 gene (ORadjusted = 0.67, 95% CI, 0.45-0.98) was also found. Moreover, MDR analysis identified a significant three-locus interaction model, involving high-risk HPV infection, TRAF3 rs12435483 and number of full-term pregnancies. Our results indicate that the MAVS rs6052130 and TRAF3 rs12435483 confer genetic susceptibility to cervical precancerous lesions. Moreover, MAVS rs6052130-mutant individuals have an increased vulnerability to high-risk HPV-induced cervical precancerous lesions.
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Affiliation(s)
- Di Xiao
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Dandan Liu
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Zihao Wen
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Xiuxia Huang
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Chengli Zeng
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Zixing Zhou
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Yajing Han
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Xiaohong Ye
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Jing Wu
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Yao Wang
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Congcong Guo
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Meiling Ou
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Shiqi Huang
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Chuican Huang
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Xiangcai Wei
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China.,Maternal and Child Health Hospital of Guangdong, Guangzhou, Guangdong Province, China
| | - Guang Yang
- Department of Pathogen Biology, School of Medicine, Jinan University, Guangzhou, Guangdong, China. .,Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong, China
| | - Chunxia Jing
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China. .,Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong, China
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49
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Abi Jaoude J, Khair D, Dagher H, Saad H, Cherfan P, Kaafarani MA, Jamaluddine Z, Ghattas H. Factors associated with Human Papilloma Virus (HPV) vaccine recommendation by physicians in Lebanon, a cross-sectional study. Vaccine 2018; 36:7562-7567. [PMID: 30420044 DOI: 10.1016/j.vaccine.2018.10.065] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 09/09/2018] [Accepted: 10/15/2018] [Indexed: 11/16/2022]
Abstract
Persistent Human Papilloma Virus (HPV) infection is associated with the development of cervical cancer, a leading cause of female death worldwide. In Lebanon, cervical cancer is the 6th most common cancer amongst girls and women aged 14-44 years. Cervical cancer is preventable through HPV vaccination; however, Lebanon does not include HPV vaccination in its national routine vaccination schedule. Hence, physician recommendation is key for patient vaccine uptake. We conducted a cross-sectional study in Beirut, Lebanon to assess factors affecting physician recommendation regarding HPV vaccination. Physicians practicing in Obstetrics and Gynecology (OBGYN), Pediatrics, Family Medicine and Infectious Diseases were included in the study. In total, 228 physicians completed the survey (28.79% response rate). The survey consisted of a set of demographic and HPV knowledge questions along with clinical vignettes. The vignettes presented theoretical patients who differed in gender, age, sexual activity, social background and whether the patient presented with his mother or not. The results show that physicians tend to recommend the vaccine more commonly for vignettes presenting female patients, with an Adjusted Odds Ratio (AOR) of 6.8. Also, physicians were more likely to recommend the vaccine for vignettes with patients coming from a non-conservative background (AOR = 2.1), vignettes where patients claim to be sexually active (AOR = 2.7) and vignettes where patients presented with their mother (AOR = 1.4). Physicians tend to recommend the vaccine less in vignettes with married patients (AOR = 0.5). Physicians with higher knowledge scores recommended the vaccine more often (AOR = 3.4). Overall, OBGYN physicians recommended the vaccine less than pediatricians (AOR = 0.5). These results show that Lebanese physicians' recommendations rely on factors external to international guidelines. The results also highlight the importance of knowledge in adequate patient consultation. Thus, improved physician awareness towards international guidelines and physician education regarding HPV vaccination is essential in order to improve patient care in Lebanon.
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Affiliation(s)
- Joseph Abi Jaoude
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Diana Khair
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Hiba Dagher
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Halim Saad
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Patrick Cherfan
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | | | - Zeina Jamaluddine
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
| | - Hala Ghattas
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
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50
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Roy S, Shankar A. HPV Vaccination of Girl Child in India: Intervention for Primary Prevention of Cervical Cancer. Asian Pac J Cancer Prev 2018; 19:2357-2358. [PMID: 30369165 PMCID: PMC6249453 DOI: 10.22034/apjcp.2018.19.9.2357] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Over the past 40 years mortality from carcinoma of the cervix has fallen due to improved treatment and the introduction of national screening programs. Awareness and health-seeking practices have been shown to be poor in many developing countries, necessitating the need for proper awareness and vaccination program The HPV vaccination is of public health importance. The Indian Academy of Pediatrics Committee on Immunization (IAPCOI) recommends offering HPV vaccine to all females who can afford the vaccine. Vaccination can be given to females as young as 9 years as well as in those aged 13–26 years who have not previously completed vaccination. The primary obstacle to HPV vaccination is financial. There are bivalent, Quadrivalent and Nonavalent HPV vaccines available based on protection against number of HPV subtypes. HPV vaccination and regular cervical screening is the most effective way to prevent cervical cancer. Parents/caregivers of child must be educated regarding HPV vaccination before offering this chemoprophylaxis against cervical cancer. Gaps and barriers to the access and delivery of HPV vaccination need to be identified, so that scientific and public health communities and civil society can be mobilised to adopt the vaccination policy.
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