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Plisko O, Zodzika J, Jermakova I, Pcolkina K, Prusakevica A, Liepniece-Karele I, Donders GGG, Rezeberga D. Aerobic Vaginitis-Underestimated Risk Factor for Cervical Intraepithelial Neoplasia. Diagnostics (Basel) 2021; 11:diagnostics11010097. [PMID: 33435407 PMCID: PMC7827831 DOI: 10.3390/diagnostics11010097] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 12/23/2020] [Accepted: 01/07/2021] [Indexed: 01/10/2023] Open
Abstract
The aim of this study is to analyse the association between vaginal microbiota and the histological finding of CIN. From July 2016 until June 2017, we included 110 consecutive patients with abnormal cervical cytology results referred for colposcopy to Riga East Clinical University Hospital Outpatient department in the study group. 118 women without cervical pathology were chosen as controls. Certified colposcopists performed interviews, gynaecological examinations and colposcopies for all participants. Material from the upper vaginal fornix was taken for pH measurement and wet-mount microscopy. Cervical biopsy samples were taken from all subjects in the study group and in case of a visual suspicion for CIN in the control group. Cervical pathology was more often associated with smoking (34.6% vs. 11.0%, p < 0.0001), low education level (47.2% vs. 25.5%, p = 0.001), increased vaginal pH (48.2% vs. 25.4%, p < 0.0001), abnormal vaginal microbiota (50% vs. 31.4%, p = 0.004) and moderate to severe aerobic vaginitis (msAV) (13.6% vs. 5.9%, p = 0.049) compared to controls. The most important independent risk factors associated with CIN2+ were smoking (OR 3.04 (95% CI 1.37–6.76), p = 0.006) and msAV (OR 3.18 (95% CI 1.13–8.93), p = 0.028). Bacterial vaginosis (BV) was found more often in CIN1 patients (8/31, 25.8%, p = 0.009) compared with healthy controls (8/118, 6.8%), or CIN2+ cases (8/79, 10.1%). In the current study msAV and smoking were the most significant factors in the development of CIN in HPV-infected women, especially high grade CIN. We suggest that AV changes are probably more important than the presence of BV in the pathogenesis of CIN and progression to cervix cancer and should not be ignored during the evaluation of the vaginal microbiota.
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Affiliation(s)
- Olga Plisko
- Department of Obstetrics and Gynecology, Riga Stradins University, LV-1007 Riga, Latvia; (J.Z.); (I.J.); (D.R.)
- Correspondence:
| | - Jana Zodzika
- Department of Obstetrics and Gynecology, Riga Stradins University, LV-1007 Riga, Latvia; (J.Z.); (I.J.); (D.R.)
- Gynecological Clinic, Riga East Clinical University Hospital, LV-1038 Riga, Latvia;
| | - Irina Jermakova
- Department of Obstetrics and Gynecology, Riga Stradins University, LV-1007 Riga, Latvia; (J.Z.); (I.J.); (D.R.)
- Gynecological Clinic, Riga East Clinical University Hospital, LV-1038 Riga, Latvia;
| | - Kristine Pcolkina
- Gynecological Clinic, Riga East Clinical University Hospital, LV-1038 Riga, Latvia;
| | | | | | - Gilbert G. G. Donders
- Femicare Clinical Research for Women, 3300 Tienen, Belgium;
- Department of Obstetrics and Gynecology, University of Antwerp, 2550 Antwerp-Edegem, Belgium
- Department of Obstetrics and Gynecology, Regional Hospital, 3300 Tienen, Belgium
| | - Dace Rezeberga
- Department of Obstetrics and Gynecology, Riga Stradins University, LV-1007 Riga, Latvia; (J.Z.); (I.J.); (D.R.)
- Gynecological Clinic, Riga East Clinical University Hospital, LV-1038 Riga, Latvia;
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Zodzika J, Krumina K, Jermakova I, Kojalo U, Plisko O, Santare D, Rezeberga D, Lazdane G. Post-reproductive aged women: a lost generation in the cervical cancer screening programme. EUR J CONTRACEP REPR 2020; 26:23-28. [PMID: 33124491 DOI: 10.1080/13625187.2020.1824269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aims of the study were to find out why some post-reproductive aged women did not participate in the organised cervical cancer screening programme in Latvia and to clarify factors that would motivate them to take part. METHODS A cross-sectional study was carried out between January and July 2017 among female patients in three general practitioner (GP) practices. GP practice nurses used the Latvian national health service database to identify women aged 25-70 who had not participated in the organised programme for the last 3 years. Participants were asked to complete a specially developed questionnaire. The results were then compared between three age groups: 25-34, 35-49 and 50-70 years. RESULTS Included in the study were 523 out of 992 women who had not attended screening; 41% were in the age group 50-70 years. Post-reproductive aged women statistically significantly more often did not take part in the programme because of lack of time (26.4%), too great a distance to the gynaecology screening clinic (10.4%), lengthy appointment waiting time (8.5%) and a belief that a smear test was unnecessary for them (8.5%); 32.1% of women in this age group indicated that if the cervical screen could be carried out by their GP it would facilitate their participation in the programme. CONCLUSION Post-reproductive aged women in Latvia often do not attend cervical cancer screening. Analysis of personal and organisational barriers confirmed that the involvement of GPs would encourage older women to participate in the organised screening programme.
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Affiliation(s)
- Jana Zodzika
- Department of Obstetrics and Gynaecology, Riga Stradins University, Riga, Latvia.,Department of Gynaecology, Riga East University Hospital, Riga, Latvia
| | - Krista Krumina
- Department of Obstetrics and Gynaecology, Riga Stradins University, Riga, Latvia.,Department of Gynaecology, Riga East University Hospital, Riga, Latvia
| | - Irina Jermakova
- Department of Obstetrics and Gynaecology, Riga Stradins University, Riga, Latvia.,Department of Gynaecology, Riga East University Hospital, Riga, Latvia
| | - Una Kojalo
- Institute of Public Health, Riga Stradins University, Riga, Latvia
| | - Olga Plisko
- Department of Obstetrics and Gynaecology, Riga Stradins University, Riga, Latvia
| | - Daiga Santare
- Science Division, Riga East University Hospital, Riga, Latvia.,Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Dace Rezeberga
- Department of Obstetrics and Gynaecology, Riga Stradins University, Riga, Latvia.,Department of Gynaecology, Riga East University Hospital, Riga, Latvia
| | - Gunta Lazdane
- Department of Obstetrics and Gynaecology, Riga Stradins University, Riga, Latvia.,Institute of Public Health, Riga Stradins University, Riga, Latvia
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Jermakova I, Rezeberga D, Liepniece-Karele I, Zodzika J, Pilmane M, Kroica J, Plisko O, Utorova M, Sivina D, Kunicina D. Correlation between abnormal cytology, HPV E6/E7 expression and cervical precancerous lesions severity. Eur J Obstet Gynecol Reprod Biol 2019. [DOI: 10.1016/j.ejogrb.2018.08.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Plisko O, Zodzika J, Rezeberga D, Jermakova I, Kroica J, Sivina D, Kunicina D, Eglite L. Associations between sexually transmitted infections and cervical precancerous lesions in Latvian women. Eur J Obstet Gynecol Reprod Biol 2019. [DOI: 10.1016/j.ejogrb.2018.08.493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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