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Sjomina O, Poļaka I, Suhorukova J, Vangravs R, Paršutins S, Knaze V, Park JY, Herrero R, Murillo R, Leja M. Randomised clinical trial: efficacy and safety of H. pylori eradication treatment with and without Saccharomyces boulardii supplementation. Eur J Cancer Prev 2024; 33:217-222. [PMID: 37942999 DOI: 10.1097/cej.0000000000000858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND Standard triple therapy is commonly prescribed Helicobacter pylori eradication regimen in Europe. However, the world is witnessing declines in eradication success. It is crucial to find better treatment options. AIMS To evaluate efficacy, compliance and side effects of H. pylori eradication treatment by adding Saccharomyces boulardii . METHODS We conducted a randomized clinical trial within the GISTAR cohort, consisting of healthy individuals aged 40-64 years. Participants were administered clarithromycin-containing triple therapy (clarithromycin 500 mg, amoxicillin 1000 mg, esomeprazole 40 mg) twice daily. Randomization was applied based on two factors: 1)addition of Saccharomyces boulardii CNCM I-745 500 mg BID or not; 2)treatment duration of 10 or 14 days. Treatment completion and adverse events were assessed via telephone interview 21-28 days after medication delivery. The efficacy was evaluated using a 13C-urea breath test (UBT) six months after treatment. RESULTS Altogether 404 participants were enrolled; data on adverse events were available from 391. Overall, 286 participants received follow-up UBT. Intention-to-treat analysis revealed higher eradication rates for 10-day probiotic treatment (70.8% vs. 54.6%, P = 0.022), but not for 14-day. Probiotic subgroups combined showed non-significantly higher efficacy in per-protocol analysis (90.6% vs. 85.0%, P = 0.183). S. boulardii reduced the frequency of adverse events ( P = 0.033) in 14-day regimen, particularly treatment-associated diarrhea ( P = 0.032). However, after the adjustment to control Type I error, results lost their significance. CONCLUSION Addition of S. boulardii to 14-day clarithromycin-containing triple regimen non-significantly lowers the likelihood of diarrhea and does not increase the eradication rate.
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Affiliation(s)
- Olga Sjomina
- Institute of Clinical and Preventive Medicine
- Faculty of Medicine, University of Latvia, Riga, Latvia
| | | | | | | | | | - Viktoria Knaze
- International Agency for Research on Cancer (IARC/WHO), Early Detection, Prevention and Infections Branch, Lyon, France
| | - Jin Young Park
- International Agency for Research on Cancer (IARC/WHO), Early Detection, Prevention and Infections Branch, Lyon, France
| | - Rolando Herrero
- International Agency for Research on Cancer (IARC/WHO), Early Detection, Prevention and Infections Branch, Lyon, France
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, Costa Rica
| | - Raul Murillo
- Hospital Universitario San Ignacio, Bogota, Columbia
| | - Mārcis Leja
- Institute of Clinical and Preventive Medicine
- Faculty of Medicine, University of Latvia, Riga, Latvia
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Steinberg J, Hughes S, Hui H, Allsop MJ, Egger S, David M, Caruana M, Coxeter P, Carle C, Onyeka T, Rewais I, Monroy Iglesias MJ, Vives N, Wei F, Abila DB, Carreras G, Santero M, O’Dowd EL, Lui G, Tolani MA, Mullooly M, Lee SF, Landy R, Hanley SJB, Binefa G, McShane CM, Gizaw M, Selvamuthu P, Boukheris H, Nakaganda A, Ergin I, Moraes FY, Timilshina N, Kumar A, Vale DB, Molina-Barceló A, Force LM, Campbell DJ, Wang Y, Wan F, Baker AL, Singh R, Salam RA, Yuill S, Shah R, Lansdorp-Vogelaar I, Yusuf A, Aggarwal A, Murillo R, Torode JS, Kliewer EV, Bray F, Chan KKW, Peacock S, Hanna TP, Ginsburg O, Hemelrijck MV, Sullivan R, Roitberg F, Ilbawi AM, Soerjomataram I, Canfell K. Risk of COVID-19 death for people with a pre-existing cancer diagnosis prior to COVID-19-vaccination: A systematic review and meta-analysis. Int J Cancer 2024; 154:1394-1412. [PMID: 38083979 PMCID: PMC10922788 DOI: 10.1002/ijc.34798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/04/2023] [Accepted: 10/20/2023] [Indexed: 02/12/2024]
Abstract
While previous reviews found a positive association between pre-existing cancer diagnosis and COVID-19-related death, most early studies did not distinguish long-term cancer survivors from those recently diagnosed/treated, nor adjust for important confounders including age. We aimed to consolidate higher-quality evidence on risk of COVID-19-related death for people with recent/active cancer (compared to people without) in the pre-COVID-19-vaccination period. We searched the WHO COVID-19 Global Research Database (20 December 2021), and Medline and Embase (10 May 2023). We included studies adjusting for age and sex, and providing details of cancer status. Risk-of-bias assessment was based on the Newcastle-Ottawa Scale. Pooled adjusted odds or risk ratios (aORs, aRRs) or hazard ratios (aHRs) and 95% confidence intervals (95% CIs) were calculated using generic inverse-variance random-effects models. Random-effects meta-regressions were used to assess associations between effect estimates and time since cancer diagnosis/treatment. Of 23 773 unique title/abstract records, 39 studies were eligible for inclusion (2 low, 17 moderate, 20 high risk of bias). Risk of COVID-19-related death was higher for people with active or recently diagnosed/treated cancer (general population: aOR = 1.48, 95% CI: 1.36-1.61, I2 = 0; people with COVID-19: aOR = 1.58, 95% CI: 1.41-1.77, I2 = 0.58; inpatients with COVID-19: aOR = 1.66, 95% CI: 1.34-2.06, I2 = 0.98). Risks were more elevated for lung (general population: aOR = 3.4, 95% CI: 2.4-4.7) and hematological cancers (general population: aOR = 2.13, 95% CI: 1.68-2.68, I2 = 0.43), and for metastatic cancers. Meta-regression suggested risk of COVID-19-related death decreased with time since diagnosis/treatment, for example, for any/solid cancers, fitted aOR = 1.55 (95% CI: 1.37-1.75) at 1 year and aOR = 0.98 (95% CI: 0.80-1.20) at 5 years post-cancer diagnosis/treatment. In conclusion, before COVID-19-vaccination, risk of COVID-19-related death was higher for people with recent cancer, with risk depending on cancer type and time since diagnosis/treatment.
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Affiliation(s)
- Julia Steinberg
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Suzanne Hughes
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Harriet Hui
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Matthew J Allsop
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Sam Egger
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Michael David
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Peter Coxeter
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Chelsea Carle
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Tonia Onyeka
- Department of Anaesthesia/Pain & Palliative Care Unit, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
- IVAN Research Institute, Enugu, Enugu Stata, Nigeria
| | - Isabel Rewais
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Maria J Monroy Iglesias
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society, and Public Health, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Nuria Vives
- Cancer Screening Unit, Institut Català d’Oncologia (ICO), Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Spain
- Ciber Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Feixue Wei
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Giulia Carreras
- Oncologic Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | - Marilina Santero
- Iberoamerican Cochrane Centre, IIB Sant Pau-Servei d’Epidemiologia Clínica i Salut Pública, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Emma L O’Dowd
- Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Gigi Lui
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | | | - Maeve Mullooly
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Shing Fung Lee
- Department of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore
- Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong, China
| | - Rebecca Landy
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville MD, United States
| | - Sharon JB Hanley
- Department of Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Gemma Binefa
- Cancer Screening Unit,Cancer Prevention and Control Program, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Early Detection of Cancer Research Group, EPIBELL Programme, Bellvitge Biomedical Research Institute, Hospitalet de Llobregat, Barcelona, Spain
| | - Charlene M McShane
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences Block B, Royal Victoria Hospital, Belfast, Northern Ireland
| | - Muluken Gizaw
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Ethiopia
- Institute for Medical Epidemiology, Biometrics and Informatics, Martin Luther University of Halle-Wittenberg, Germany
- NCD Working Group, School of Public Health, Addis Ababa University, Ethiopia
| | - Poongulali Selvamuthu
- Chennai Antiviral Research and Treatment Center and Clinical Research Site (CART CRS), Infectious Diseases Medical Center, Voluntary Health Services, Chennai, India
| | - Houda Boukheris
- University Abderrahmane Mira of Bejaia, School of Medicine, Algeria
- Departement of Epidemiology and Preventive Medicine, University Hospital of Bejaia, Algeria
| | - Annet Nakaganda
- Department of Cancer Epidemiology and Clinical Trials, Uganda Cancer Institute, Uganda
| | - Isil Ergin
- Department of Public Health, Faculty of Medicine, Ege University, Turkey
| | - Fabio Ynoe Moraes
- Department of Oncology, Queen’s University, Kingston, Ontario, Canada
| | - Nahari Timilshina
- Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
| | - Ashutosh Kumar
- Department of Anatomy, All India Institute of Medical Sciences-Patna, Patna, India
| | - Diama B Vale
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Brazil
| | - Ana Molina-Barceló
- Cancer and Public Health Research Unit, Biomedical Research Foundation FISABIO, Valencia, Spain
| | - Lisa M Force
- Department of Health Metrics Sciences and Department of Pediatrics, Division of Hematology/Oncology, University of Washington, United States
| | - Denise Joan Campbell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Yuqing Wang
- School of Public Health, University of Sydney, Sydney, Australia
| | - Fang Wan
- School of Public Health, University of Sydney, Sydney, Australia
| | - Anna-Lisa Baker
- School of Public Health, University of Sydney, Sydney, Australia
| | - Ramnik Singh
- School of Public Health, University of Sydney, Sydney, Australia
| | - Rehana Abdus Salam
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Susan Yuill
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- School of Public Health, University of Sydney, Sydney, Australia
| | - Richa Shah
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Iris Lansdorp-Vogelaar
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Aasim Yusuf
- Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore & Peshawar, Pakistan
| | - Ajay Aggarwal
- Department of Health Services Research and Policy, School of Hygiene and Tropical Medicine, King’s College London, London, United Kingdom
- Department of Oncology, Guy’s & St Thomas NHS Trust, London, United Kingdom
| | - Raul Murillo
- Centro Javeriano De Oncologia - Hospital Universitario San Ignacio, Bogotá, Colombia
- Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Julie S Torode
- Institute of Cancer Policy, King’s College London, London, United Kingdom
- Research Oncology, Bermondsey Wing, Guy’s Hospital, SE1 9RT, London, United Kingdom
| | - Erich V Kliewer
- Department of Cancer Control Research, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Kelvin KW Chan
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Canadian Centre for Applied Research in Cancer Control, Vancouver, British Columbia, Canada
| | - Stuart Peacock
- Department of Cancer Control Research, BC Cancer Research Institute, Vancouver, British Columbia, Canada
- Canadian Centre for Applied Research in Cancer Control, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Timothy P Hanna
- Division of Cancer Care and Epidemiology, Cancer Research Institute at Queen’s University, Kingston, Ontario, Canada
- Department of Oncology and Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Ophira Ginsburg
- Center for Global Health, National Cancer Institute, Maryland, United States
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society, and Public Health, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Richard Sullivan
- Institute of Cancer Policy, King’s College London, London, United Kingdom
| | - Felipe Roitberg
- Department of Non-Communicable Diseases, World Health Organisation, Geneva, Switzerland
- Hospital Sírio Libanês, São Paulo, Brazil
- Rede Ebserh, Rede Brasileira de Serviços Hospitalares, Brasília, Brazil
| | | | | | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
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3
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Downham L, Rol ML, Forestier M, Romero P, Mendoza L, Mongelós P, Picconi MA, Colucci MC, Padin VM, Flores AP, Zúñiga M, Ferrera A, Cabrera Y, Crispín MF, Ramirez AT, Cele L, Diop-Ndiaye H, Samaté D, Manga P, Thiam FB, Rodriguez MI, DSouza JP, Nyaga VN, Diop M, Sebitloane M, Sánchez GI, Teran C, Calderon A, Wiesner C, Murillo R, Herrero R, Baena A, Almonte M. Field experience with the 8-HPV-type oncoprotein test for cervical cancer screening among HPV-positive women living with and without HIV in LMICs. Int J Cancer 2024. [PMID: 38602045 DOI: 10.1002/ijc.34953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 04/12/2024]
Abstract
Overexpression of HPV-oncoproteins E6 and E7 is necessary for HPV-driven cervical carcinogenesis. Hence, these oncoproteins are promising disease-specific biomarkers. We assessed the technical and operational characteristics of the 8-HPV-type OncoE6/E7 Cervical Test in different laboratories using cervical samples from HPV-positive women living with (WLWH) and without HIV. The 8-HPV-type OncoE6/E7 Test (for short: "OncoE6/E7 test") was performed in 2833 HIV-negative women and 241 WLWH attending multicentric studies in Latin America (ESTAMPA study), and in Africa (CESTA study). Oncoprotein positivity were evaluated at each testing site, according to HIV status as well as type-specific agreement with HPV-DNA results. A feedback questionnaire was given to the operators performing the oncoprotein test to evaluate their impression and acceptability regarding the test. The OncoE6/E7 test revealed a high positivity rate heterogeneity across all testing sites (I2: 95.8%, p < .01) with significant lower positivity in WLWH compared to HIV-negative women (12% vs 25%, p < .01). A similar HPV-type distribution was found between HPV DNA genotyping and oncoprotein testing except for HPV31 and 33 (moderate agreement, k = 0.57). Twenty-one laboratory technicians were trained on oncoprotein testing. Despite operators' concerns about the time-consuming procedure and perceived need for moderate laboratory experience, they reported the OncoE6/E7 test as easy to perform and user-friendly for deployment in resource-limited settings. The high positivity rate variability found across studies and subjectivity in test outcome interpretation could potentially results in oncoprotein false positive/negative, and thus the need for further refinements before implementation of the oncoprotein testing in screen-triage-and-treat approaches is warranted.
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Affiliation(s)
- Laura Downham
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Mary Luz Rol
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Mathilde Forestier
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Pilar Romero
- Instituto Nacional de Cancerología, Bogota, Colombia
| | - Laura Mendoza
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Pamela Mongelós
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | | | - María Celeste Colucci
- Instituto Nacional de Enfermedades Infecciosas-ANLIS Dr Malbrán, Buenos Aires, Argentina
| | - Valeria Mariel Padin
- Instituto Nacional de Enfermedades Infecciosas-ANLIS Dr Malbrán, Buenos Aires, Argentina
| | - Ana Paula Flores
- Agencia Costarricense de Investigaciones Biomédicas (ACIB), Fundación Inciensa, Guanacaste, Costa Rica
| | - Michael Zúñiga
- Agencia Costarricense de Investigaciones Biomédicas (ACIB), Fundación Inciensa, Guanacaste, Costa Rica
| | - Annabelle Ferrera
- Instituto de Investigaciones en Microbiología, Escuela de Microbiología, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Yessy Cabrera
- Instituto de Investigaciones en Microbiología, Escuela de Microbiología, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Marcela Farfan Crispín
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | - Arianis Tatiana Ramirez
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Londiwe Cele
- University of Kwazulu Natal, Durban, South Africa
| | | | - Dianke Samaté
- Laboratoire Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Senegal
| | - Pascaline Manga
- Laboratoire Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Senegal
| | | | - Maria Isabel Rodriguez
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Jyoshma P DSouza
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Victoria Nyawira Nyaga
- Department of Cancer Epidemiology, Scientific Institute of Public Health, Brussels, Belgium
| | - Mamadou Diop
- Laboratoire Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Senegal
| | | | | | - Carolina Teran
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | | | | | - Raul Murillo
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Rolando Herrero
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
- Caja Costarricense del Seguro Social, Puntarenas, Costa Rica
| | - Armando Baena
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Maribel Almonte
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
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Martínez-Ramos N, Ávila L, Rodríguez S, Ortiz M, Pira D, Rangel V, Ariza A, Betancourt-Niño N, Aldana-Rojas G, García-Padilla D, Monroy M, Sánchez JF, Cadena C, Quintero L, Bueno D, Prieto M, Martínez-Martínez A, Albarracín SL, Murillo R. Attitudes scale toward cancer-related cognitive changes - an initial Colombian validation. Eur Rev Med Pharmacol Sci 2023; 27:7738-7748. [PMID: 37667952 DOI: 10.26355/eurrev_202308_33428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
OBJECTIVE The aim of this study was to develop an initial valid tool to measure attitudes toward cancer-related cognitive changes. SUBJECTS AND METHODS After revising the literature, three main dimensions were hypothesized. Eight judges were contacted to obtain content validity evidence. A robust Exploratory Factor Analysis (EFA) was performed via a parallel analysis with an Unweighted Least Squares (ULS) estimator and polychoric correlations. The results were crossed with sociodemographic variables to find possible statistical differences and estimate the size effect. Analysis was performed in the software Factor and the statistical package R. RESULTS A sample of 374 participants was obtained, involving oncology patients, their caregivers, and people from the general community. A statistical fit was found in two dimensions: Awareness and Judgments [root mean squared error of approximation (RMSEA) = 0.042, standardized root mean square residual (SRMR) = 0.02, comparative fit index (CFI) = 0.99, Tucker-Lewis index (TLI) = 0.98] with a moderate correlation between them (r = 0.612). Optimal reliability indices were obtained for the total scale and its dimensions. No real statistical difference was found between sociodemographic variables; the interpretation norms were established via the quartiles. CONCLUSIONS The first attempt to measure the construct of interest was developed with two primary validity evidence based on the content and its internal structure. This instrument could help strengthen the prevention of cancer-related cognitive changes. More research is needed to adhere more valid evidence to the scale.
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Lucas E, Murillo R, Arrossi S, Bárcena M, Chami Y, Nessa A, Perera S, Silva P, Sangrajrang S, Muwonge R, Basu P. Quantification of impact of COVID-19 pandemic on cancer screening programmes - a case study from Argentina, Bangladesh, Colombia, Morocco, Sri Lanka, and Thailand. eLife 2023; 12:e86527. [PMID: 37191660 PMCID: PMC10188105 DOI: 10.7554/elife.86527] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/24/2023] [Indexed: 05/17/2023] Open
Abstract
It is quite well documented that the COVID-19 pandemic disrupted cancer screening services in all countries, irrespective of their resources and healthcare settings. While quantitative estimates on reduction in volume of screening tests or diagnostic evaluation are readily available from the high-income countries, very little data are available from the low- and middle-income countries (LMICs). From the CanScreen5 global cancer screening data repository we identified six LMICs through purposive sampling based on the availability of cancer screening data at least for the years 2019 and 2020. These countries represented those in high human development index (HDI) categories (Argentina, Colombia, Sri Lanka, and Thailand) and medium HDI categories (Bangladesh and Morocco). No data were available from low HDI countries to perform similar analysis. The reduction in the volume of tests in 2020 compared to the previous year ranged from 14.1% in Bangladesh to 72.9% in Argentina (regional programme) for cervical screening, from 14.2% in Bangladesh to 49.4% in Morocco for breast cancer screening and 30.7% in Thailand for colorectal cancer screening. Number of colposcopies was reduced in 2020 compared to previous year by 88.9% in Argentina, 38.2% in Colombia, 27.4% in Bangladesh, and 52.2% in Morocco. The reduction in detection rates of CIN 2 or worse lesions ranged from 20.7% in Morocco to 45.4% in Argentina. Reduction of breast cancer detection by 19.1% was reported from Morocco. No association of the impact of pandemic could be seen with HDI categories. Quantifying the impact of service disruptions in screening and diagnostic tests will allow the programmes to strategize how to ramp up services to clear the backlogs in screening and more crucially in further evaluation of screen positives. The data can be used to estimate the impact on stage distribution and avoidable mortality from these common cancers.
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Affiliation(s)
- Eric Lucas
- International Agency for Research on CancerLyonFrance
| | - Raul Murillo
- Hospital Universitario San IgnacioBogotaColombia
| | | | | | - Youssef Chami
- Foundation Lalla Salma Cancer prevention and treatmentRabatMorocco
| | - Ashrafun Nessa
- Bangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | | | | | | | | | - Partha Basu
- International Agency for Research on CancerLyonFrance
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6
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Valls J, Baena A, Venegas G, Celis M, González M, Sosa C, Santin JL, Ortega M, Soilán A, Turcios E, Figueroa J, Rodríguez de la Peña M, Figueredo A, Beracochea AV, Pérez N, Martínez-Better J, Lora O, Jiménez JY, Giménez D, Fleider L, Salgado Y, Martínez S, Bellido-Fuentes Y, Flores B, Tatti S, Villagra V, Cruz-Valdez A, Terán C, Sánchez GI, Rodríguez G, Picconi MA, Ferrera A, Mendoza L, Calderón A, Murillo R, Wiesner C, Broutet N, Luciani S, Pérez C, Darragh TM, Jerónimo J, Herrero R, Almonte M. Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus: results from the ESTAMPA multicentric screening study. Lancet Glob Health 2023; 11:e350-e360. [PMID: 36796982 PMCID: PMC10020136 DOI: 10.1016/s2214-109x(22)00545-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 02/16/2023]
Abstract
BACKGROUND Colposcopy, currently included in WHO recommendations as an option to triage human papillomavirus (HPV)-positive women, remains as the reference standard to guide both biopsy for confirmation of cervical precancer and cancer and treatment approaches. We aim to evaluate the performance of colposcopy to detect cervical precancer and cancer for triage in HPV-positive women. METHODS This cross-sectional, multicentric screening study was conducted at 12 centres (including primary and secondary care centres, hospitals, laboratories, and universities) in Latin America (Argentina, Bolivia, Colombia, Costa Rica, Honduras, Mexico, Paraguay, Peru, and Uruguay). Eligible women were aged 30-64 years, sexually active, did not have a history of cervical cancer or treatment for cervical precancer or a hysterectomy, and were not planning to move outside of the study area. Women were screened with HPV DNA testing and cytology. HPV-positive women were referred to colposcopy using a standardised protocol, including biopsy collection of observed lesions, endocervical sampling for transformation zone (TZ) type 3, and treatment as needed. Women with initial normal colposcopy or no high-grade cervical lesions on histology (less than cervical intraepithelial neoplasia [CIN] grade 2) were recalled after 18 months for another HPV test to complete disease ascertainment; HPV-positive women were referred for a second colposcopy with biopsy and treatment as needed. Diagnostic accuracy of colposcopy was assessed by considering a positive test result when the colposcopic impression at the initial colposcopy was positive minor, positive major, or suspected cancer, and was considered negative otherwise. The main study outcome was histologically confirmed CIN3+ (defined as grade 3 or worse) detected at the initial visit or 18-month visit. FINDINGS Between Dec 12, 2012, and Dec 3, 2021, 42 502 women were recruited, and 5985 (14·1%) tested positive for HPV. 4499 participants with complete disease ascertainment and follow-up were included in the analysis, with a median age of 40·6 years (IQR 34·7-49·9). CIN3+ was detected in 669 (14·9%) of 4499 women at the initial visit or 18-month visit (3530 [78·5%] negative or CIN1, 300 [6·7%] CIN2, 616 [13·7%] CIN3, and 53 [1·2%] cancers). Sensitivity was 91·2% (95% CI 88·9-93·2) for CIN3+, whereas specificity was 50·1% (48·5-51·8) for less than CIN2 and 47·1% (45·5-48·7) for less than CIN3. Sensitivity for CIN3+ significantly decreased in older women (93·5% [95% CI 91·3-95·3] in those aged 30-49 years vs 77·6% [68·6-85·0] in those aged 50-65 years; p<0·0001), whereas specificity for less than CIN2 significantly increased (45·7% [43·8-47·6] vs 61·8% [58·7-64·8]; p<0·0001). Sensitivity for CIN3+ was also significantly lower in women with negative cytology than in those with abnormal cytology (p<0·0001). INTERPRETATION Colposcopy is accurate for CIN3+ detection in HPV-positive women. These results reflect ESTAMPA efforts in an 18-month follow-up strategy to maximise disease detection with an internationally validated clinical management protocol and regular training, including quality improvement practices. We showed that colposcopy can be optimised with proper standardisation to be used as triage in HPV-positive women. FUNDING WHO; Pan American Health Organization; Union for International Cancer Control; National Cancer Institute (NCI); NCI Center for Global Health; National Agency for the Promotion of Research, Technological Development, and Innovation; NCI of Argentina and Colombia; Caja Costarricense de Seguro Social; National Council for Science and Technology of Paraguay; International Agency for Research on Cancer; and all local collaborative institutions.
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Affiliation(s)
- Joan Valls
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.
| | - Armando Baena
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Gino Venegas
- Clínica Angloamericana, Lima, Peru; Escuela de Medicina Humana, Universidad de Piura, Lima, Peru
| | - Marcela Celis
- Instituto Nacional de Cancerología, Bogotá, Colombia
| | | | - Carlos Sosa
- Hospital Monseñor Victor Manuel Sanabria Martínez, Puntarenas, Costa Rica
| | - Jorge Luis Santin
- Hospital Monseñor Victor Manuel Sanabria Martínez, Puntarenas, Costa Rica
| | - Marina Ortega
- Hospital Nacional, Ministerio de Salud Pública y Bienestar Social, Itauguá, Paraguay; Instituto Nacional del Cáncer, Ministerio de Salud Pública y Bienestar Social, Capiatá, Paraguay
| | - Ana Soilán
- Hospital Nacional, Ministerio de Salud Pública y Bienestar Social, Itauguá, Paraguay; Hospital Materno Infantil de San Lorenzo, Ministerio de Salud Pública y Bienestar Social, San Lorenzo, Paraguay
| | - Elmer Turcios
- Programa Nacional contra el Cáncer, Tegucigalpa, Honduras
| | | | | | - Alicia Figueredo
- Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | | | - Natalia Pérez
- Hospital de Clínicas, Facultad de Medicina, Montevideo, Uruguay
| | | | - Oscar Lora
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia; Hospital Gineco-Obstétrico y Neonatal Dr Jaime Sánchez Porcel, Sucre, Bolivia
| | | | - Diana Giménez
- Hospital Materno Infantil de Trinidad, Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay
| | - Laura Fleider
- Hospital de Clínicas, José de San Martín, Buenos Aires, Argentina
| | - Yuly Salgado
- Instituto Nacional de Cancerología, Bogotá, Colombia
| | | | | | - Bettsy Flores
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | - Silvio Tatti
- Hospital de Clínicas, José de San Martín, Buenos Aires, Argentina
| | | | | | - Carolina Terán
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | | | | | | | - Annabelle Ferrera
- Instituto de Infecciones en Microbiología, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Laura Mendoza
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Alejandro Calderón
- Caja Costarricense de Seguro Social, Región Pacífico Central, San José, Costa Rica
| | - Raul Murillo
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France; Instituto Nacional de Cancerología, Bogotá, Colombia
| | | | - Nathalie Broutet
- Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland
| | | | - Carlos Pérez
- Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Teresa M Darragh
- Department of Pathology, University of California, San Francisco, CA, USA
| | - José Jerónimo
- Liga contra el Cáncer-Peru, Lima, Peru; US National Cancer Institute, Bethesda, MD, USA
| | - Rolando Herrero
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France; Agencia Costarricense de Investigaciones Biomédicas, Fundación Inciensa, Guanacaste, Costa Rica
| | - Maribel Almonte
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France; Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland
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7
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Mouron S, Bueno MJ, Lluch A, Manso L, Calvo I, Cortes J, Garcia-Saenz JA, Gil-Gil M, Martinez-Janez N, Apala JV, Caleiras E, Ximénez-Embún P, Muñoz J, Gonzalez-Cortijo L, Murillo R, Sánchez-Bayona R, Cejalvo JM, Gómez-López G, Fustero-Torre C, Sabroso-Lasa S, Malats N, Martinez M, Moreno A, Megias D, Malumbres M, Colomer R, Quintela-Fandino M. Phosphoproteomic analysis of neoadjuvant breast cancer suggests that increased sensitivity to paclitaxel is driven by CDK4 and filamin A. Nat Commun 2022; 13:7529. [PMID: 36477027 PMCID: PMC9729295 DOI: 10.1038/s41467-022-35065-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
Precision oncology research is challenging outside the contexts of oncogenic addiction and/or targeted therapies. We previously showed that phosphoproteomics is a powerful approach to reveal patient subsets of interest characterized by the activity of a few kinases where the underlying genomics is complex. Here, we conduct a phosphoproteomic screening of samples from HER2-negative female breast cancer receiving neoadjuvant paclitaxel (N = 130), aiming to find candidate biomarkers of paclitaxel sensitivity. Filtering 11 candidate biomarkers through 2 independent patient sets (N = 218) allowed the identification of a subgroup of patients characterized by high levels of CDK4 and filamin-A who had a 90% chance of achieving a pCR in response to paclitaxel. Mechanistically, CDK4 regulates filamin-A transcription, which in turn forms a complex with tubulin and CLIP-170, which elicits increased binding of paclitaxel to microtubules, microtubule acetylation and stabilization, and mitotic catastrophe. Thus, phosphoproteomics allows the identification of explainable factors for predicting response to paclitaxel.
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Affiliation(s)
- S Mouron
- Breast Cancer Clinical Research Unit Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - M J Bueno
- Breast Cancer Clinical Research Unit Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - A Lluch
- Medical Oncology Department, Hospital Clínico Universitario, Valencia, Spain
| | - L Manso
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - I Calvo
- Medical Oncology Department MD, Anderson Cancer Center Madrid, Madrid, Spain
| | - J Cortes
- International Breast Cancer Center Quiron Group, Barcelona, Spain
- Vall d'Hebron Institute of Oncology, Vall d'Hebron Hospital, Barcelona, Spain
| | - J A Garcia-Saenz
- Medical Oncology Department, Hospital Clinico San Carlos, Madrid, Spain
| | - M Gil-Gil
- Medical Oncoogy Department Institut, Catala d'Oncologia-IDIBELL L'Hospitalet de, Llobregat, Spain
| | - N Martinez-Janez
- Medical Oncology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - J V Apala
- Breast Cancer Clinical Research Unit Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - E Caleiras
- Histopathology Unit Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - Pilar Ximénez-Embún
- Proteomics Unit Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - J Muñoz
- Proteomics Unit Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - L Gonzalez-Cortijo
- Medical Oncology Department, Hospital Universitario Quironsalud, Madrid, Spain
| | - R Murillo
- Pathology Department, Hospital Universitario Quironsalud, Madrid, Spain
| | - R Sánchez-Bayona
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J M Cejalvo
- Medical Oncology Department, Hospital Clínico Universitario, Valencia, Spain
| | - G Gómez-López
- Bioinformatics Unit Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - C Fustero-Torre
- Bioinformatics Unit Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - S Sabroso-Lasa
- Genetic & Molecular Epidemiology Group Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - N Malats
- Genetic & Molecular Epidemiology Group Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - M Martinez
- Pathology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Moreno
- Pathology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - D Megias
- Confocal Microscopy Unit Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - M Malumbres
- Cell Division and Cancer Group Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain
| | - R Colomer
- Medical Oncology Department, Hospital Universitario La Princesa, Madrid, Spain
- Endowed Chair of Personalized Precision Medicine Universidad Autonoma de Madrid (UAM) - Fundacion Instituto Roche, Madrid, Spain
| | - M Quintela-Fandino
- Breast Cancer Clinical Research Unit Centro Nacional de Investigaciones Oncológicas - CNIO, Madrid, Spain.
- Endowed Chair of Personalized Precision Medicine Universidad Autonoma de Madrid (UAM) - Fundacion Instituto Roche, Madrid, Spain.
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8
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Prudden HJ, Achilles SL, Schocken C, Broutet N, Canfell K, Akaba H, Basu P, Bhatla N, Chirenje ZM, Delany-Moretlwe S, Denny L, Gamage DG, Herrero R, Hutubessy R, Villa LL, Murillo R, Schiller JT, Stanley M, Temmerman M, Zhao F, Ogilvie G, Kaslow DC, Dull P, Gottlieb SL. Understanding the public health value and defining preferred product characteristics for therapeutic human papillomavirus (HPV) vaccines: World Health Organization consultations, October 2021-March 2022. Vaccine 2022; 40:5843-5855. [PMID: 36008233 DOI: 10.1016/j.vaccine.2022.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022]
Abstract
The World Health Organization (WHO) global strategy to eliminate cervical cancer (CxCa) could result in >62 million lives saved by 2120 if strategy targets are reached and maintained: 90% of adolescent girls receiving prophylactic human papillomavirus (HPV) vaccine, 70% of women receiving twice-lifetime cervical cancer screening, and 90% of cervical pre-cancer lesions and invasive CxCa treated. However, the cost and complexity of CxCa screening and treatment approaches has hampered scale-up, particularly in low- and middle-income countries (LMICs), and new approaches are needed. Therapeutic HPV vaccines (TxV), which could clear persistent high-risk HPV infection and/or cause regression of pre-cancerous lesions, are in early clinical development and might offer one such approach. During October 2021 to March 2022, WHO, in collaboration with the Bill and Melinda Gates Foundation, convened a series of global expert consultations to lay the groundwork for understanding the potential value of TxV in the context of current CxCa prevention efforts and for defining WHO preferred product characteristics (PPCs) for TxV. WHO PPCs describe preferences for vaccine attributes that would help optimize vaccine value and use in meeting the global public health need. This paper reports on the main discussion points and findings from the expert consultations. Experts identified several ways in which TxV might address challenges in current CxCa prevention programmes, but emphasized that the potential value of TxV will depend on their degree of efficacy and how quickly they can be developed and implemented relative to ongoing scale-up of existing interventions. Consultation participants also discussed potential use-cases for TxV, important PPC considerations (e.g., vaccine indications, target populations, and delivery strategies), and critical modelling needs for predicting TxV impact and cost-effectiveness.
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Affiliation(s)
| | | | | | | | - Karen Canfell
- The Daffodil Centre, The University of Sydney, Cancer Council NSW, Australia
| | | | - Partha Basu
- International Agency for Research on Cancer, France
| | - Neerja Bhatla
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | - Lynette Denny
- University of Cape Town, SA MRC Gynaecology Cancer Research, South Africa
| | | | | | | | | | | | | | | | | | - Fanghui Zhao
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Gina Ogilvie
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Canada
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9
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Bruni L, Serrano B, Roura E, Alemany L, Cowan M, Herrero R, Poljak M, Murillo R, Broutet N, Riley LM, de Sanjose S. Cervical cancer screening programmes and age-specific coverage estimates for 202 countries and territories worldwide: a review and synthetic analysis. Lancet Glob Health 2022; 10:e1115-e1127. [PMID: 35839811 PMCID: PMC9296658 DOI: 10.1016/s2214-109x(22)00241-8] [Citation(s) in RCA: 98] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Cervical cancer screening coverage is a key monitoring indicator of the WHO cervical cancer elimination plan. We present global, regional, and national cervical screening coverage estimates against the backdrop of the 70% coverage target set by WHO. METHODS In this review and synthetic analysis, we searched scientific literature, government websites, and official documentation to identify official national recommendations and coverage data for cervical cancer screening for the 194 WHO member states and eight associated countries and territories published from database inception until Oct 30, 2020, supplemented with a formal WHO country consultation from Nov 27, 2020, to Feb 12, 2021. We extracted data on the year of introduction of recommendations, the existence of individual invitation to participate, financing of screening tests, primary screening and triage tests used, recommended ages and screening intervals, use of self-sampling, and use of screen-and-treat approaches. We also collected coverage data, either administrative or survey-based, as disaggregated as possible by age and for any available screening interval. According to data completeness and representativeness, different statistical models were developed to produce national age-specific coverages by screening interval, which were transformed into single-age datapoints. Missing data were imputed. Estimates were applied to the 2019 population and aggregated by region and income level. FINDINGS We identified recommendations for cervical screening in 139 (69%) of 202 countries and territories. Cytology was the primary screening test in 109 (78%) of 139 countries. 48 (35%) of 139 countries recommended primary HPV-based screening. Visual inspection with acetic acid was the most recommended test in resource-limited settings. Estimated worldwide coverage in women aged 30-49 years in 2019 was 15% in the previous year, 28% in the previous 3 years, and 32% in the previous 5 years, and 36% ever in lifetime. An estimated 1·6 billion (67%) of 2·3 billion women aged 20-70 years, including 662 million (64%) of 1·0 billion women aged 30-49 years, had never been screened for cervical cancer. 133 million (84%) of 158 million women aged 30-49 years living in high-income countries had been screened ever in lifetime, compared with 194 million (48%) of 404 million women in upper-middle-income countries, 34 million (9%) of 397 million women in lower-middle-income countries, and 8 million (11%) of 74 million in low-income countries. INTERPRETATION Two in three women aged 30-49 years have never been screened for cervical cancer. Roll-out of screening is very low in low-income and middle-income countries, where the burden of disease is highest. The priority of the WHO elimination campaign should be to increase both screening coverage and treatment of detected lesions; however, expanding the efforts of surveillance systems in both coverage and quality control are major challenges to achieving the WHO elimination target. FUNDING Instituto de Salud Carlos III, European Regional Development Fund, Secretariat for Universities and Research of the Department of Business and Knowledge of the Government of Catalonia, and Horizon 2020. TRANSLATIONS For the French, Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Laia Bruni
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.
| | - Beatriz Serrano
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Esther Roura
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Melanie Cowan
- Surveillance, Monitoring, and Reporting Unit, Department of Noncommunicable Diseases, WHO, Geneva, Switzerland
| | - Rolando Herrero
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, San José, Costa Rica; Early Detection and Prevention Section, International Agency for Research on Cancer, WHO, Lyon, France
| | - Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Raul Murillo
- Early Detection and Prevention Section, International Agency for Research on Cancer, WHO, Lyon, France; Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Nathalie Broutet
- Department of Reproductive Health and Research, WHO, Geneva, Switzerland
| | - Leanne M Riley
- Surveillance, Monitoring, and Reporting Unit, Department of Noncommunicable Diseases, WHO, Geneva, Switzerland
| | - Silvia de Sanjose
- National Cancer Institute, Rockville, MD, USA; ISGlobal, Barcelona, Spain
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10
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Robles C, Rudzite D, Polaka I, Sjomina O, Tzivian L, Kikuste I, Tolmanis I, Vanags A, Isajevs S, Liepniece-Karele I, Razuka-Ebela D, Parshutin S, Murillo R, Herrero R, Young Park J, Leja M. Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment-Results from the GISTAR Pilot Study. Diagnostics (Basel) 2022; 12:1746. [PMID: 35885649 PMCID: PMC9325279 DOI: 10.3390/diagnostics12071746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 07/06/2022] [Accepted: 07/13/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction−−Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods−−Within the intervention arm of the GISTAR population-based study, participants with abnormal pepsinogen values by ELISA or latex-agglutination tests, or abnormal gastrin-17 by ELISA and a subset of subjects with all normal biomarker values were referred for upper endoscopy with biopsies. Performance of biomarkers, corrected by verification bias, to detect five composite outcomes based on atrophy, intestinal metaplasia, dysplasia or cancer was explored. Results−−Data from 1045 subjects were analysed, of those 273 with normal biomarker results. Both pepsinogen assays showed high specificity (>93%) but poor sensitivity (range: 18.4−31.1%) that slightly improved when lesions were restricted to corpus location (40.5%) but decreased when dysplasia and prevalent cancer cases were included (23.8%). Adding gastrin-17 detection, sensitivity reached 33−45% while specificity decreased (range: 61.1−62%) and referral rate for upper endoscopy increased to 38.6%. Conclusions−−Low sensitivity of pepsinogen assays is a limiting factor for their use in population-based primary gastric cancer screening, however their high specificity could be useful for triage.
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Affiliation(s)
- Claudia Robles
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, France; (R.M.); (R.H.); (J.Y.P.)
- Cancer Epidemiology Research Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain
| | - Dace Rudzite
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
- Department of Research, Riga East University Hospital, 1038 Riga, Latvia
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
| | - Olga Sjomina
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
| | - Lilian Tzivian
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
- Digestive Diseases Centre GASTRO, 1586 Riga, Latvia; (I.T.); (A.V.)
| | - Ivars Tolmanis
- Digestive Diseases Centre GASTRO, 1586 Riga, Latvia; (I.T.); (A.V.)
| | - Aigars Vanags
- Digestive Diseases Centre GASTRO, 1586 Riga, Latvia; (I.T.); (A.V.)
| | - Sergejs Isajevs
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
- Department of Research, Riga East University Hospital, 1038 Riga, Latvia
- Academic Histology Laboratory, 1073 Riga, Latvia
| | - Inta Liepniece-Karele
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
- Department of Research, Riga East University Hospital, 1038 Riga, Latvia
- Academic Histology Laboratory, 1073 Riga, Latvia
| | - Danute Razuka-Ebela
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
| | - Sergej Parshutin
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
| | - Raul Murillo
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, France; (R.M.); (R.H.); (J.Y.P.)
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá 11001, Colombia
| | - Rolando Herrero
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, France; (R.M.); (R.H.); (J.Y.P.)
- Agencia Costarricense de Investigaciones Biomedicas, Fundacion INCIENSA, San Jose 2250, Costa Rica
| | - Jin Young Park
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, 69372 Lyon, France; (R.M.); (R.H.); (J.Y.P.)
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 1007 Riga, Latvia; (D.R.); (I.P.); (O.S.); (L.T.); (I.K.); (S.I.); (I.L.-K.); (D.R.-E.); (S.P.); (M.L.)
- Department of Research, Riga East University Hospital, 1038 Riga, Latvia
- Digestive Diseases Centre GASTRO, 1586 Riga, Latvia; (I.T.); (A.V.)
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11
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Leja M, Cine E, Poļaka I, Daugule I, Murillo R, Parshutin S, Ražuka-Ebela D, Rotberga L, Anarkulova L, Kriķe P, Šantare D, Tzivian L, Herrero R, Park JY. Factors influencing participation in preventive interventions for gastric cancer: the results from the GISTAR study. Eur J Cancer Prev 2022; 31:128-136. [PMID: 34519690 DOI: 10.1097/cej.0000000000000682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Search-and-treat strategy for Helicobacter pylori and surveillance of patients with precancerous lesions are recommended to decrease the burden of gastric cancer in high-risk areas. We aimed to evaluate the acceptance of the target population to these strategies. METHODS We applied a search-and-treat strategy combined with biomarker screening (pepsinogens I and II, gastrin-17) for atrophic gastritis to healthy individuals aged 40-64 years within the GISTAR Pilot study. Different means of invitation were evaluated - direct telephone calls, letters of invitation via the general practitioners. Participants with altered biomarker results were invited to undergo upper gastrointestinal endoscopy. H.pylori positive individuals were offered eradication therapy. Data on the compliance to the treatment and reasons for noncompliance were collected via telephone. RESULTS Altogether 3453 participants were enrolled. The attendance of women participants was 1.9 times higher although active invitation strategies were mainly targeting men. The yield for the telephone invitations was higher than for mail-delivered invitations (2.1 calls vs. 7.7 letters required to recruit one study subject). Out of 661 individuals reached with the invitation to undergo upper endoscopy, 520 (78.7%) attended the procedure. Out of 1185 study subjects eligible for eradication, 810 (68.4%) accepted it. Of those having received the medication, 765(94.4%) completed it. The reasons for nonparticipation were the overall misconception of the importance of screening, busy schedule and others. CONCLUSIONS While only the minority of the target population participated in the gastric cancer prevention strategy, relatively high compliance was seen among the participants. The acceptance rate and the identified reasons for refusing to participate in our study indicate that there is a need to raise gastric cancer awareness and its existent preventive strategies within the general population for their successful implementation in the community.
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Affiliation(s)
- Mārcis Leja
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia
- Department of Research, Riga East University hospital
- Digestive Diseases Centre GASTRO
| | - Eva Cine
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia
| | - Inese Poļaka
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia
- Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Ilva Daugule
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia
| | - Raul Murillo
- International Agency for Research on Cancer (IARC), Lyon, France
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio. Bogotá, Colombia
| | - Sergei Parshutin
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia
- Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Danute Ražuka-Ebela
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia
| | - Laura Rotberga
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia
| | - Linda Anarkulova
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia
| | - Petra Kriķe
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia
| | - Daiga Šantare
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia
- Department of Research, Riga East University hospital
| | - Lilian Tzivian
- Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia
| | - Rolando Herrero
- International Agency for Research on Cancer (IARC), Lyon, France
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, San Jose, Costa Rica
| | - Jin Young Park
- International Agency for Research on Cancer (IARC), Lyon, France
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12
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Broutet N, Jeronimo J, Kumar S, Almonte M, Murillo R, Huy NVQ, Denny L, Kapambwe S, Bhatla N, Sebitloane M, Zhao F, Gravitt P, Adsul P, Rangaraj A, Dalal S, Newman M, Chowdhury R, Church K, Nakisige C, Diop M, Parham G, Thomson KA, Basu P, Steyn P. Implementation research to accelerate scale-up of national screen and treat strategies towards the elimination of cervical cancer. Prev Med 2022; 155:106906. [PMID: 34896155 DOI: 10.1016/j.ypmed.2021.106906] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/24/2021] [Accepted: 11/28/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cervical cancer is a significant public health problem, with 570,000 new cases and 300,000 deaths of women per year globally, mostly in low- and middle-income countries. In 2018 the WHO Director General made a call to action for the elimination of cervical cancer as a public health problem. MAIN BODY New thinking on programmatic approaches to introduce emerging technologies and screening and treatment interventions of cervical precancer at scale is needed to achieve elimination goals. Implementation research (IR) is an important yet underused tool for facilitating scale-up of evidence-based screening and treatment interventions, as most research has focused on developing and evaluating new interventions. It is time for countries to define their specific IR needs to understand acceptability, feasibility, and cost-effectiveness of interventions as to design and ensure effective implementation, scale-up, and sustainability of evidence-based screening and treatment interventions. WHO convened an expert advisory group to identify priority IR questions for HPV-based screening and treatment interventions in population-based programmes. Several international organizations are supporting large scale introduction of screen-and-treat approaches in many countries, providing ideal platforms to evaluate different approaches and strategies in diverse national contexts. CONCLUSION For reducing cervical cancer incidence and mortality, the readiness of health systems, the reach and effectiveness of new technologies and algorithms for increasing screening and treatment coverage, and the factors that support sustainability of these programmes need to be better understood. Answering these key IR questions could provide actionable guidance for countries seeking to implement the WHO Global Strategy towards cervical cancer elimination.
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Affiliation(s)
| | - Jose Jeronimo
- Consultant for the US National Cancer Institute, MD, USA
| | | | - Maribel Almonte
- International Agency for Research in Cancer (IARC), Lyon, France
| | | | | | | | | | - Neerja Bhatla
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Fanghui Zhao
- Chinese Academy of Medical Sciences, Beijing, China
| | - Patti Gravitt
- University of Maryland Baltimore, Baltimore, MD, USA
| | - Prajakta Adsul
- University of New Mexico Comprehensive Cancer Center, USA
| | | | - Shona Dalal
- World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Mamadou Diop
- Cancer Institute, Le Dantec Hospital, Cheikh Anta Diop University, Senegal
| | - Groesbeck Parham
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kerry A Thomson
- PATH, Sexual & Reproductive Health Program, Seattle, WA, USA
| | - Partha Basu
- International Agency for Research in Cancer (IARC), Lyon, France
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13
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Teoh SP, Hoo YY, Murillo R, Zuluaga M, Tsunoda A, Lombe D, Sullivan R, Bhoo-Pathy N. Contingency planning for cancer care in low- and middle-income countries during the COVID-19 pandemic: a rapid assessment for future disaster resilience. Ecancermedicalscience 2022; 16:1339. [PMID: 35242220 PMCID: PMC8831112 DOI: 10.3332/ecancer.2022.1339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Indexed: 12/04/2022] Open
Abstract
Background Many countries appear to be ill-prepared in their emergency responses towards the Corona Virus Disease 2019 (COVID-19) pandemic, particularly in managing chronic diseases such as cancer. We aimed to gain insight on the preparedness of health systems within low- and middle-income countries (LMICs) in maintaining delivery of cancer care amid the pandemic. Methods We performed a rapid review of publications focusing on emergency contingency plans for cancer care during the pandemic in LMICs. An online desk research was conducted to identify relevant policy documents, guidelines or scientific publications. Results Very few LMICs had readily accessible documents to ensure continuity in delivery of cancer care during the pandemic. A majority of publications were focused on delivery of cancer treatment whereas early detection, diagnosis and delivery of supportive and survivorship care received very little attention. Far fewer of the published guidelines appear to have been formulated at the national level by governmental agencies. A vast majority of publications constituted consensus guidelines from professional societies, followed by sharing of best practices from local institutions. Overall, three main strategies have been recommended to maintain delivery of cancer care amid the pandemic in LMICs: 1) Modification of cancer treatment regimens, 2) Changes in methods of administration of curative and supportive cancer care and 3) Implementation of generic measures to reduce the risk of COVID-19 infection in healthcare settings. Conclusion All LMICs should consider collating best practices from the current pandemic and translating them into an explicit cancer preparedness plan, which can be escalated during future disasters.
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Affiliation(s)
- Soo-Peng Teoh
- Centre for Epidemiology and Evidence-Based Medicine, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Yee-Yin Hoo
- Hospital Serdang, 43000 Kajang, Selangor, Malaysia
| | - Raul Murillo
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Kra 7° # 40-62, Bogotá, Colombia
| | - María Zuluaga
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Kra 7° # 40-62, Bogotá, Colombia
| | - Audrey Tsunoda
- Erasto Gaertner Hospital, PPGTS/Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Dorothy Lombe
- Regional Cancer Treatment Services, MidCentral District Health Board, 4410 New Zealand
| | - Richard Sullivan
- Institute of Cancer Policy, Global Oncology Group, School of Cancer Sciences, King’s College London, Strand, London, WC2R 2LS, United Kingdom
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence-Based Medicine, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
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14
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Veses A, Sanahuja-Parejo O, Navarro M, López J, Murillo R, Callén M, García T. From laboratory scale to pilot plant: Evaluation of the catalytic co-pyrolysis of grape seeds and polystyrene wastes with CaO. Catal Today 2021. [DOI: 10.1016/j.cattod.2020.04.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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15
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de Vries E, Leal Arenas FA, van der Heide A, Gempeler Rueda FE, Murillo R, Morales O, Diaz-Amado E, Rodríguez N, Gonzalez BJ, Castilblanco Delgado DS, Calvache JA. Medical decisions concerning the end of life for cancer patients in three Colombian hospitals - a survey study. BMC Palliat Care 2021; 20:161. [PMID: 34657613 PMCID: PMC8520825 DOI: 10.1186/s12904-021-00853-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/20/2021] [Indexed: 12/02/2022] Open
Abstract
Background Cancer patients’ end-of-life care may involve complex decision-making processes. Colombia has legislation regarding provision of and access to palliative care and is the only Latin American country with regulation regarding euthanasia. We describe medical end-of-life decision-making practices among cancer patients in three Colombian hospitals. Methods Cancer patients who were at the end-of-life and attended in participating hospitals were identified. When these patients deceased, their attending physician was invited to participate. Attending physicians of 261 cancer patients (out of 348 identified) accepted the invitation and answered a questionnaire regarding end-of-life decisions: a.) decisions regarding the withdrawal or withholding of potentially life-prolonging medical treatments, b.) intensifying measures to alleviate pain or other symptoms with hastening of death as a potential side effect, and c.) the administration, supply or prescription of drugs with an explicit intention to hasten death. For each question addressing the first two decision types, we asked if the decision was fully or partially made with the intention or consideration that it may hasten the patient’s death. Results Decisions to withdraw potentially life-prolonging treatment were made for 112 (43%) patients, 16 of them (14%) with an intention to hasten death. For 198 patients (76%) there had been some decision to not initiate potentially life-prolonging treatment. Twenty-three percent of patients received palliative sedation, 97% of all patients received opioids. Six patients (2%) explicitly requested to actively hasten their death, for two of them their wish was fulfilled. In another six patients, medications were used with the explicit intention to hasten death without their explicit request. In 44% (n = 114) of all cases, physicians did not know if their patient had any advance care directives, 26% (n = 38) of physicians had spoken to the patient regarding the possibility of certain treatment decisions to hasten death where this applied. Conclusions Decisions concerning the end of life were common for patients with cancer in three Colombian hospitals, including euthanasia and palliative sedation. Physicians and patients often fail to communicate about advance care directives and potentially life-shortening effects of treatment decisions. Specific end-of-life procedures, patients’ wishes, and availability of palliative care should be further investigated. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00853-9.
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Affiliation(s)
- Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Cra. 7 No 40-62 Edificio Hospital San Ignacio, Piso 2, Bogota, Colombia.
| | - Fabián Alexander Leal Arenas
- Instituto Nacional de Cancerología, Cl. 1 No 9-85, Bogota, Colombia.,Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Carrera 7ª No. 40-62 Edificio Santacoloma (No 30), Bogota, Colombia
| | - Agnes van der Heide
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Fritz E Gempeler Rueda
- Anesthesiology Department, Pontificia Universidad Javeriana, Cra. 7 No 40-62 Edificio Hospital San Ignacio, Bogota, Colombia.,Clinical Ethics Service, Hospital Universitario San Ignacio, Cra. 7 No 40-62, Bogota, Colombia
| | - Raul Murillo
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Carrera 7ª No. 40-62 Edificio Santacoloma (No 30), Bogota, Colombia.,Department of Internal Medicine, Pontificia Universidad Javeriana, Cra. 7 No 40-62 Edificio Hospital San Ignacio, Bogotá, Colombia
| | - Olga Morales
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Carrera 7ª No. 40-62 Edificio Santacoloma (No 30), Bogota, Colombia
| | - Eduardo Diaz-Amado
- Instituto de Bioética, Pontificia Universidad Javeriana, Tv. 4 #42, Bogota, Colombia
| | - Nelcy Rodríguez
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Cra. 7 No 40-62 Edificio Hospital San Ignacio, Piso 2, Bogota, Colombia
| | - Beatriz Juliana Gonzalez
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Carrera 7ª No. 40-62 Edificio Santacoloma (No 30), Bogota, Colombia
| | - Danny Steven Castilblanco Delgado
- Instituto Nacional de Cancerología, Cl. 1 No 9-85, Bogota, Colombia.,Universidad Militar Nueva Granada, Carrera 11 n.° 101-80, Bogota, Colombia
| | - Jose A Calvache
- Department of Anesthesiology, Universidad del Cauca, Cl 5 #4-70, Popayán, Cauca, Colombia.,Department of Anesthesiology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
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16
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Basu P, Lucas E, Zhang L, Muwonge R, Murillo R, Nessa A. Leveraging vertical COVID-19 investments to improve monitoring of cancer screening programme - A case study from Bangladesh. Prev Med 2021; 151:106624. [PMID: 34023359 PMCID: PMC9755639 DOI: 10.1016/j.ypmed.2021.106624] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/11/2021] [Accepted: 05/16/2021] [Indexed: 02/06/2023]
Abstract
Cancer screening programs from majority of the low- and middle-income countries (LMICs) report screening coverage as the only performance indicator, and that too measured through population-based sample surveys. Such information is unreliable and has very little value in assessing programmatic quality and impact. Regular monitoring of key process and outcome indicators based on data collected through a robust information system is essential to ensure quality of a screening programme. Fragmented health systems, limited resources and absence of a culture of systematic evaluation are the major hindrances for most of the LMICs to build electronic information systems to manage screening. The COVID-19 pandemic has created an impetus for the countries to customize the freely available District Health Information Software (DHIS2) to collect electronic data to track the outbreaks and manage containment measures. In the present article we present Bangladesh as an exemplar LMIC that has a (DHIS2) based integrated health information system gradually upgraded to collect individual data of the participants to the national cervical cancer screening program. Such efforts paid rich dividends as the screening program was switched from opportunistic to a population-based one. Moreover, the electronic system could report impact of the pandemic on cancer screening on a monthly basis. The aggregate number of women screened in the year 2020 was 14.1% less compared to 2019. The monthly rate of screening during peak of the outbreak was only 5.1% of the previous year. The rate rapidly recovered as the program intensified screening in the hard-to-reach regions less affected by the pandemic and expanded the outreach services. Other LMICs may emulate Bangladesh example. Customizing the information system developed for pandemic surveillance to collect cancer screening data will help them build back the screening programs better.
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Affiliation(s)
- Partha Basu
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France.
| | - Eric Lucas
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Li Zhang
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Richard Muwonge
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Raul Murillo
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France; Centro Javerinao de Oncología - Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Ashrafun Nessa
- Department of Obstetrics and Gynecology, Bangabandhu Sheikh, Mujib Medical University, Shahbag, Dhaka, Bangladesh
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17
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Lewison G, Owen GI, Gomez H, Cazap E, Murillo R, Saldaña KU, Dreyer M, Tsunoda A, De La Jara JJ. Cancer Research in Latin America, 2014-2019, and its Disease Burden. JSCIRES 2021. [DOI: 10.5530/jscires.10.1s.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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18
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Mandrik O, Tolma E, Zielonke N, Meheus F, Ordóñez-Reyes C, Severens JL, Murillo R. Systematic reviews as a "lens of evidence": Determinants of participation in breast cancer screening. J Med Screen 2021; 28:70-79. [PMID: 32517538 PMCID: PMC8167916 DOI: 10.1177/0969141320930743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/25/2020] [Accepted: 05/11/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the determinants of the participation rate in breast cancer screening programs by conducting a systematic review of reviews. METHODS We conducted a systematic search in PubMed via Medline, Scopus, Embase, and Cochrane identifying the literature up to April 2019. Out of 2258 revealed unique abstracts, we included 31 reviews, from which 25 were considered as systematic. We applied the Walsh & McPhee Systems Model of Clinical Preventive Care to systematize the determinants of screening participation. RESULTS The reviews, mainly in high-income settings, reported a wide range for breast cancer screening participation rate: 16-90%. The determinants of breast cancer screening participation were simple low-cost interventions such as invitation letters, basic information on screening, multiple reminders, fixed appointments, prompts from healthcare professionals, and healthcare organizational factors (e.g. close proximity to screening facility). More complex interventions (such as face-to-face counselling or home visits), mass media or improved access to transport should not be encouraged by policy makers unless other information appears. The repeated participation in mammography screening was consistently high, above 62%. Previous positive experience with screening influenced the repeated participation in screening programs. The reviews were inconsistent in the use of terminology related to breast cancer screening participation, which may have contributed to the heterogeneity in the reported outcomes. CONCLUSIONS This study shows that consistent findings of systematic reviews bring more certainty into the conclusions on the effects of simple invitation techniques, fixed appointments and prompts, as well as healthcare organizational factors on promoting participation rate in screening mammography.
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Affiliation(s)
- O Mandrik
- School of Health and Related Research, Health Economic and Decision Science (HEDS), The University of Sheffield, Sheffield, UK
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France
| | - E Tolma
- Faculty of Public Health, Kuwait University, Jabriya, Kuwait
| | - N Zielonke
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - F Meheus
- Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France
| | - C Ordóñez-Reyes
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - JL Severens
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - R Murillo
- Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
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Caicedo-Martinez M, Li B, Gonzalez-Motta A, Gamboa O, Bobadilla I, Wiesner C, Murillo R. Radiation Oncology in Colombia: An Opportunity for Improvement in the Postconflict Era. Int J Radiat Oncol Biol Phys 2021; 109:1142-1150. [PMID: 33714525 DOI: 10.1016/j.ijrobp.2020.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/05/2020] [Indexed: 10/21/2022]
Affiliation(s)
| | - Benjamin Li
- University of California, San Francisco, San Francisco, California; Rayos Contra Cancer, Nashville, Tennessee
| | - Alejandro Gonzalez-Motta
- Division of Radiation Oncology, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia; Asociación Colombiana de Radioterapia Oncológica, Bogotá, Colombia
| | - Oscar Gamboa
- Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Ivan Bobadilla
- Asociación Colombiana de Radioterapia Oncológica, Bogotá, Colombia; Division of Radiation Oncology, Centro de Control de Cáncer, Clínica del Country, Bogotá, Colombia
| | | | - Raul Murillo
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia; Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
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20
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Sanchez Forero RA, Olejua Villa PA, Rocha Morales A, Murillo R. Evaluación de Errores de Posicionamiento en los 6 Grados de Libertad en Pacientes con Cáncer de próstata tratados con radioterapia. Rev Urol 2021. [DOI: 10.1055/s-0040-1714726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Resumen
Objetivos Determinar la magnitud de los errores de posicionamiento en los 6 grados de libertad y calcular el Margen a CTV para un protocolo adaptado en pacientes con cáncer de próstata temprano y localmente avanzado en un centro de referencia en Colombia.
Métodos Se realizó un estudio observacional prospectivo en 61 pacientes con cáncer de próstata tratados con radioterapia en el Centro Javeriano de Oncología del Hospital Universitario San Ignacio durante el 2018, con toma de imágenes volumétricas de rayos x durante los primeros 3 días de tratamiento obteniéndose un promedio en errores traslacionales y rotacionales. Posteriormente se tomaron imágenes semanales. Además, se realizó el cálculo del margen al PTV y variaciones en vejiga y recto durante el tratamiento.
Resultados Un total de 508 imágenes fueron registradas durante las 8 semanas de tratamiento, los errores traslacionales y rotacionales tuvieron un comportamiento alrededor de cero sin diferencias significativas inclusive en pacientes con IMC > = 25. También se calculó el margen al PTV encontrándose entre 5 y 8 mm, en cuanto a las medidas de vejiga y recto no se encontraron diferencias estadísticamente significativas en las imágenes adquiridas durante la radioterapia.
Conclusiones De acuerdo a los datos encontrados en este estudio, una adecuada reproducibilidad en paciente con cáncer de próstata puede ser encontrada usando el método de registro rígido de la anatomía pélvica ósea, promediando las 3 primeras imágenes y posteriormente con imágenes semanales, en centros con alta demanda de pacientes garantizando así una adecuada precisión del tratamiento.
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Affiliation(s)
| | | | | | - Raul Murillo
- Hospital Universitario San Ignacio, Bogotá, Colombia
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Razuka-Ebela D, Zile I, Tzivian L, Ebela I, Polaka I, Parshutin S, Santare D, Murillo R, Herrero R, Young Park J, Leja M. Does Family History of Cancer Influence Undergoing Screening and Gastrointestinal Investigations? J Gastrointestin Liver Dis 2020; 29:523-528. [PMID: 33118535 DOI: 10.15403/jgld-813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS Although a family history of cancer (FHC) can modify the lifestyle and attitudes towards participation in cancer screening programs, studies on this relationship show mixed results and vary across populations. The objectives of the study were to compare sociodemographic characteristics, history of gastrointestinal (GI) investigations and Helicobacter pylori eradication, and modifiable cancer risk factors between those with FHC and those with no FHC (NFHC), and to investigate the association between FHC and a history of GI investigations. METHODS A total of 3,455 questionnaires from the pilot study of the "Helicobacter pylori eradication and pepsinogen testing for prevention of gastric cancer mortality (GISTAR study)" in Latvia were analysed. We compared sociodemographic characteristics and history of GI investigations between participants with self- reported FHC and NFHC. Binary logistic regression models adjusted for socio-demographic characteristics and modifiable cancer risk factors were built for a FHC and each GI investigation. RESULTS Participants with a FHC were more likely to be women, have a higher education and less likely to have harmful habits (smoking, alcohol consumption) than those with NFHC. Participants with a FHC were approximately twice as likely to report recent colorectal investigations specifically for screening, than those with NFHC. In fully adjusted logistic regression models, FHC was significantly associated with a recent history of faecal occult blood tests (FOBTs), colonoscopies, and colorectal investigations (FOBT or colonoscopy) specifically for screening as part of the national organized screening programme. CONCLUSION Our results indicate that those with a FHC have different patterns of health-related behaviour than those with NFHC.
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Affiliation(s)
- Danute Razuka-Ebela
- Faculty of Medicine, University of Latvia; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Irisa Zile
- Faculty of Medicine, University of Latvia, Riga, Latvia.
| | - Lilian Tzivian
- Faculty of Medicine, University of Latvia; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia; Holon Institute of Technology, Holon, Israel.
| | - Inguna Ebela
- Faculty of Medicine, University of Latvia, Riga, Latvia.
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Sergei Parshutin
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Daiga Santare
- Faculty of Medicine, University of Latvia; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Raul Murillo
- Hospital Universitario San Ignacio, Bogota, Columbia.
| | - Rolando Herrero
- International Agency for Research on Cancer, Lyon, France; Agencia Costarricense de Investigaciones Biomédicas, Costa Rica.
| | - Jin Young Park
- International Agency for Research on Cancer, Lyon, France.
| | - Marcis Leja
- Faculty of Medicine, University of Latvia; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
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Razuka-Ebela D, Polaka I, Parshutin S, Santare D, Ebela I, Murillo R, Herrero R, Tzivian L, Young Park J, Leja M. Sociodemographic, Lifestyle and Medical Factors Associated with Helicobacter Pylori Infection. J Gastrointestin Liver Dis 2020; 29:319-327. [PMID: 32919416 DOI: 10.15403/jgld-870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 07/07/2020] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS The prevalence of Helicobacter pylori (H. pylori) infection is higher in developing countries and is often linked to lower socioeconomic status. Few studies have investigated the association between H. pylori and individual level characteristics in Europe, where several countries have a high prevalence of H. pylori infection. The study aimed to identify risk factors for H. pylori infection among adults in a large clinical trial in Latvia. METHODS 1,855 participants (40-64 years) of the "Multicenter randomized study of H. pylori eradication and pepsinogen testing for prevention of gastric cancer mortality" (GISTAR study) in Latvia tested for H. pylori IgG antibodies were included in a cross-sectional analysis. Sociodemographic, lifestyle and medical factors were compared for participants seropositive (H. pylori+) and seronegative. Mutually adjusted odds ratios (OR) were calculated for H. pylori+ and factors significant in univariate analysis (education, smoking, binge drinking, several dietary habits, history of H. pylori eradication and disease), adjusting for age, gender and income. RESULTS Of the participants 1,044 (55.4%) were H. pylori seropositive. The infection was associated with current (OR: 1.34, 95%CI: 1.01-1.78) and former (OR: 1.38; 95%CI: 1.03-1.85) smoking, binge drinking (OR: 1.35; 95%CI: 1.03-1.78), having ≥200g dairy daily (OR: 1.37; 95%CI: 1.11-1.69), and very hot food/drinks (OR: 1.32; 95%CI: 1.03-1.69) and inversely with ≥400g vegetables/fruit daily (OR: 0.76; 95%CI: 0.60-0.96), history of H. pylori eradication (OR: 0.57; 95%CI: 0.39-0.84), peptic ulcer (OR: 0.55; 95%CI: 0.38-0.80) and cardiovascular disease (OR: 0.78; 95%CI: 0.61-0.99). CONCLUSIONS After mutual adjustment, H. pylori seropositivity was associated with lifestyle and in particular dietary factors rather than socioeconomic indicators in contrast to the majority of other studies.
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Affiliation(s)
- Danute Razuka-Ebela
- Faculty of Medicine, University of Latvia, Riga; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Sergei Parshutin
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Daiga Santare
- Faculty of Medicine, University of Latvia, Riga; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Inguna Ebela
- Faculty of Medicine, University of Latvia, Riga, Latvia.
| | - Raul Murillo
- Hospital Universitario San Ignacio, Bogota, Columbia.
| | | | - Lilian Tzivian
- Faculty of Medicine, University of Latvia, Riga, Latvia; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia; Holon Institute of Technology, Holon, Israel.
| | - Jin Young Park
- International Agency for Research on Cancer, Lyon, France.
| | - Marcis Leja
- Faculty of Medicine, University of Latvia, Riga; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
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Herrero R, Heise K, Acevedo J, Cook P, Gonzalez C, Gahona J, Cortés R, Collado L, Beltrán ME, Cikutovic M, Gonzalez P, Murillo R, Leja M, Megraud F, Hernandez MDLL, Barbier S, Park JY, Ferreccio C. Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile. PLoS One 2020; 15:e0237515. [PMID: 32898138 PMCID: PMC7478833 DOI: 10.1371/journal.pone.0237515] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 07/28/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Regional variations in gastric cancer incidence are not explained by prevalence of Helicobacter pylori, the main cause of the disease, with several areas presenting high H. pylori prevalence but low gastric cancer incidence. The IARC worldwide H. pylori prevalence surveys (ENIGMA) aim at systematically describing age and sex-specific prevalence of H. pylori infection around the world and generating hypotheses to explain regional variations in gastric cancer risk. METHODS We selected age- and sex-stratified population samples in two areas with different gastric cancer incidence and mortality in Chile: Antofagasta (lower rate) and Valdivia (higher rate). Participants were 1-69 years old and provided interviews and blood for anti-H. pylori antibodies (IgG, VacA, CagA, others) and atrophy biomarkers (pepsinogens). RESULTS H. pylori seroprevalence (Age-standardized to world population) and antibodies against CagA and VacA were similar in both sites. H. pylori seroprevalence was 20% among children <10 years old, 40% among 10-19 year olds, 60% in the 20-29 year olds and close to or above 80% in those 30+ years. The comparison of the prevalence of known and potential H. pylori cofactors in gastric carcinogenesis between the high and the low risk area showed that consumption of chili products was significantly higher in Valdivia and daily non-green vegetable consumption was more common in Antofagasta. Pepsinogen levels suggestive of gastric atrophy were significantly more common and occurred at earlier ages in Valdivia, the higher risk area. In a multivariate model combining both study sites, age, chili consumption and CagA were the main risk factors for gastric atrophy. CONCLUSIONS The prevalence of H. pylori infection and its virulence factors was similar in the high and the low risk area, but atrophy was more common and occurred at younger ages in the higher risk area. Dietary factors could partly explain higher rates of atrophy and gastric cancer in Valdivia. IMPACT The ENIGMA study in Chile contributes to better understanding regional variations in gastric cancer incidence and provides essential information for public health interventions.
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Affiliation(s)
- Rolando Herrero
- International Agency for Research on Cancer, Lyon, France
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, Costa Rica
| | - Katy Heise
- Hospital Cancer Registry, Hospital Base Valdivia, Valdivia, Chile
| | | | - Paz Cook
- Public Health Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, ACCDis, Santiago, Chile
| | - Claudia Gonzalez
- Secretaría Regional Ministerial de Salud, Antofagasta Region, Chile
| | - Jocelyne Gahona
- Faculty of Health Sciences, Universidad de Antofagasta, Antofagasta, Chile
| | - Raimundo Cortés
- Faculty of Health Sciences, Universidad de Antofagasta, Antofagasta, Chile
| | - Luis Collado
- Institute of Biochemistry and Microbiology, Faculty of Sciences, Universidad Austral de Chile, Valdivia, Chile
| | | | - Marcos Cikutovic
- Faculty of Health Sciences, Universidad de Antofagasta, Antofagasta, Chile
| | - Paula Gonzalez
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, Costa Rica
| | - Raul Murillo
- International Agency for Research on Cancer, Lyon, France
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Francis Megraud
- Bordeaux University, INSERM, UMR1053, BaRITOn, Team 2 "Helicobacter Infection, Inflammation and Cancer", Bordeaux, France
- Pellegrin University Hospital, Bacteriology Laboratory, French National Reference Center for Campylobacters and Helicobacters, Bordeaux, France
| | | | | | - Jin Young Park
- International Agency for Research on Cancer, Lyon, France
| | - Catterina Ferreccio
- Public Health Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, ACCDis, Santiago, Chile
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Gasenko E, Leja M, Polaka I, Hegmane A, Murillo R, Bordin D, Link A, Kulju M, Mochalski P, Shani G, Malfertheiner P, Herrero R, Haick H. How do international gastric cancer prevention guidelines influence clinical practice globally? Eur J Cancer Prev 2020; 29:400-407. [PMID: 32740165 DOI: 10.1097/cej.0000000000000580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Clinical guidelines recommend particular approaches, including 'screen-and-treat' strategy for Helicobacter pylori, to prevent gastric cancer. However, little of this is implemented in clinical practice. The aim of the study was to identify barriers to implementation of international guidelines. A web-based questionnaire distributed globally to specialists in the field. Altogether 886 responses from 75 countries were received. Of the responders, 570 (64%) were men of mean age 47 years. There were 606 gastroenterologists and 65 epidemiologists among the responders. Altogether, 79.8% of the responders disagreed that the burden of gastric cancer is a diminishing problem. 'Screen-and-treat' strategy for H. pylori in the responder's country was considered appropriate by 44.4%, inappropriate by 24.3%, with 31.3% being uncertain. Population-based screening for gastric cancer was considered appropriate in the respective home-country by 62.2%, in other areas - but not the home country - by 27.6%, and inappropriate by 10.2%. As a screening tool, upper endoscopy was acceptable by 35.6%, upper X-ray series by 55.3%, pepsinogens by 26.2% and breath-tests by 23.4%; accuracy, cost-effectiveness and feasibility among the tests varied widely. The attitude towards H. pylori vaccination was that 4.6% of the responders were eager to start vaccination immediately, 55.9% were supporting vaccination but considered that more data are required 12% were negative, and 27.6% did not have an opinion. In general, the attitude of the specialists was in line with guidelines, but was not always translated into clinical practice, particularly in the case of 'screen-and-treat' strategy.
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Affiliation(s)
- Evita Gasenko
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia
- Riga East University Hospital, Riga, Latvia
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia
- Riga East University Hospital, Riga, Latvia
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia
| | - Alinta Hegmane
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia
- Riga East University Hospital, Riga, Latvia
| | - Raul Murillo
- International Agency for Research on Cancer, Lyon, France
| | - Dmitry Bordin
- Moscow Clinical Research Centre, Moscow city Department of Healthcare, Moscow, Russia
| | - Alexander Link
- Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Minna Kulju
- VTT, Technical Research Centre of Finland, Helsinki, Finland
| | - Pawel Mochalski
- Institute for Breath Research of the University of Innsbruck, Dornbirn, Austria
- Institute of Chemistry, Jan Kochanowski University, Kielce, Poland
| | - Gidi Shani
- Technion, Israel Institute of Technology, Haifa, Israel
| | | | | | - Hossam Haick
- Technion, Israel Institute of Technology, Haifa, Israel
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Vorsters A, Bosch FX, Bonanni P, Franco EL, Baay M, Simas C, Waheed DEN, Castro C, Murillo R, Trujillo L, Wiesner C, Muñoz N. Prevention and control of HPV infection and HPV-related cancers in Colombia- a meeting report. BMC Proc 2020; 14:8. [PMID: 32577128 PMCID: PMC7307134 DOI: 10.1186/s12919-020-00192-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The Human Papillomavirus (HPV) Prevention and Control Board is an independent multidisciplinary board of international experts that disseminates relevant information on HPV to a broad array of stakeholders and provides guidance on strategic, technical and policy issues in the implementation of HPV control programs. In response to drastic drop of vaccine coverage following the adverse event crisis in Carmen del Bolivar, Colombia, the HPV Prevention and Control Board in collaboration with the Colombian National Cancer Institute and Colombian League Against Cancer convened a meeting in Bogota, Columbia (November 2018). The goal of the meeting was to bring together national and international group of experts to report the disease burden, epidemiology and surveillance of HPV and HPV-related cancers, to discuss the successes and especially the challenges of HPV vaccination and screening in Colombia, as well as the lessons learnt from neighbouring countries. The meeting provided a platform to confer various stakeholder's perspectives, including the role of the Colombian healthcare system and to catalyse various parts of the public health community in Colombia into effective action. The conclusion of the meeting included following suggestions to strengthen HPV prevention and control: 1) Re-introducing school-based vaccine programs, 2) Integrating primary and secondary prevention programs, 3) Developing an innovative crisis communication plan targeting healthcare workers, teachers and general population, 4) Building trust through efficient and timely communication, 5) Building strong relationship with media to ensure a stable vaccination campaign support, and 6) Promoting empathy among healthcare professionals towards patients to build trust and communicate effectively.
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Affiliation(s)
- Alex Vorsters
- Centre for Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium
| | - Francesc Xavier Bosch
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology, L'Hospitalet De Llobregat, Barcelona, Spain.,Open University of Catalonia, Barcelona, Spain
| | - Paolo Bonanni
- University of Florence, Health Sciences, Florence, Italy
| | | | - Marc Baay
- P95, Epidemiology and Pharmacovigilance Consulting and Services, Leuven, Belgium
| | - Clarissa Simas
- Infectious Disease and Epidemiology (IDE), London School of Hygiene and Tropical Medicine, London, UK
| | - Dur-E-Nayab Waheed
- Centre for Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium
| | - Carlos Castro
- Colombian League against Cancer Bogota, Bogota, Colombia
| | - Raul Murillo
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogota, Colombia
| | - Lina Trujillo
- Instituto Nacional de Cancerología, Bogota, Colombia
| | | | - Nubia Muñoz
- Instituto Nacional de Cancerología, Bogota, Colombia
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Ginsburg O, Yip CH, Brooks A, Cabanes A, Caleffi M, Dunstan Y. J, Gyawali B, McCormack V, de Anderson MM, Mehrotra R, Mohar A, Murillo R, Pace LE, Paskett ED, Romanoff A, Rositch AF, Scheel J, Schneidman M, Unger-Saldana K, Vanderpuye V, Wu TY, Yuma S, Dvaladze A, Duggan C, Anderson BO. Breast cancer early detection: A phased approach to implementation. Cancer 2020; 126 Suppl 10:2379-2393. [PMID: 32348566 PMCID: PMC7237065 DOI: 10.1002/cncr.32887] [Citation(s) in RCA: 182] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 12/16/2022]
Abstract
When breast cancer is detected and treated early, the chances of survival are very high. However, women in many settings face complex barriers to early detection, including social, economic, geographic, and other interrelated factors, which can limit their access to timely, affordable, and effective breast health care services. Previously, the Breast Health Global Initiative (BHGI) developed resource-stratified guidelines for the early detection and diagnosis of breast cancer. In this consensus article from the sixth BHGI Global Summit held in October 2018, the authors describe phases of early detection program development, beginning with management strategies required for the diagnosis of clinically detectable disease based on awareness education and technical training, history and physical examination, and accurate tissue diagnosis. The core issues address include finance and governance, which pertain to successful planning, implementation, and the iterative process of program improvement and are needed for a breast cancer early detection program to succeed in any resource setting. Examples are presented of implementation, process, and clinical outcome metrics that assist in program implementation monitoring. Country case examples are presented to highlight the challenges and opportunities of implementing successful breast cancer early detection programs, and the complex interplay of barriers and facilitators to achieving early detection for breast cancer in real-world settings are considered.
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Affiliation(s)
- Ophira Ginsburg
- Perlmutter Cancer Center, Section for Global Health, Division of Health and Behavior, Department of Population Health, New York University Langone Health, NY, USA
| | - Cheng-Har Yip
- University of Malaya, Kuala Lumpur, Malaysia
- Ramsay Sime Darby Health Care Kuala Lumpur, Malaysia
| | - Ari Brooks
- Dept. of Surgery, University of Pennsylvania, PA, USA
| | | | - Maira Caleffi
- Breast Center Hospital Moinhos de Vento Porto Alegre, Brazil
| | - Jorge Dunstan Y.
- Department of Breast, Skin and Soft Tissue Sarcomas Surgery Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Bishal Gyawali
- Department of Oncology, Department of Public Health Sciences and Division of Cancer Care and Epidemiology, Queen’s University, Kingston, Ontario, Canada
| | | | | | | | - Alejandro Mohar
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, UNAM, Mexico
| | - Raul Murillo
- Centro Javeriano de Oncología – Hospital Universitario San Ignacio. Colombia
- Facultad de Medicina – Pontificia Universidad Javeriana, Colombia
| | - Lydia E. Pace
- Division of Women’s Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
| | - Electra D. Paskett
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH
| | - Anya Romanoff
- Department of Surgery, Division of Surgical Oncology, Breast Surgery, The Icahn School of Medicine at The Mount Sinai Hospital, New York, NY, USA
| | - Anne F. Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John Scheel
- Dept. of Radiology, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington Seattle, WA, USA
| | - Miriam Schneidman
- Health, Nutrition and Population Global Practice, The World Bank Group
| | - Karla Unger-Saldana
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, UNAM, Mexico
| | - Verna Vanderpuye
- National Center for Oncology, Radiotherapy and Nuclear Medicine, Accra, Ghana
| | - Tsu-Yin Wu
- Center for Health Disparities Innovation and Studies, Eastern Michigan University, MI, USA
| | - Safina Yuma
- Dept. of Reproductive and Child Health, Ministry of Health, Community Development, Gender, Elderly & Children, Dodoma, Tanzania
| | - Allison Dvaladze
- Breast Health Global Initiative, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- University of Washington, Seattle, WA, USA
| | - Catherine Duggan
- Breast Health Global Initiative, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Benjamin O. Anderson
- Breast Health Global Initiative, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Departments of Surgery and Global Health Medicine, University of Washington, Seattle, Washington, USA
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Mandrik O, Ekwunife OI, Meheus F, Severens JL(H, Lhachimi S, Uyl‐de Groot CA, Murillo R. Systematic reviews as a "lens of evidence": Determinants of cost-effectiveness of breast cancer screening. Cancer Med 2019; 8:7846-7858. [PMID: 31568702 PMCID: PMC6912065 DOI: 10.1002/cam4.2498] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 12/30/2022] Open
Abstract
Systematic reviews with economic components are important decision tools for stakeholders seeking to evaluate technologies, such as breast cancer screening (BCS) programs. This overview of systematic reviews explores the determinants of the cost-effectiveness of BCS and assesses the quality of secondary evidence. The search identified 30 systematic reviews that reported on the determinants of the cost-effectiveness of BCS, including the costs of breast cancer and BCS. While the quality of the reviews varied widely, only four out of 30 papers were considered to be of a high quality. We did not identify publication bias in the original evidence on the cost-effectiveness of mammography screening; however, we highlight a need for improved clarity in both reporting and data verification. The reviews consisted mainly of studies from high-income countries. Breast cancer costs varied widely among the studies. Factors leading to higher costs included: time (diagnosis and last months before death), later stage or metastases, recurrence of the disease, age below 64 years and type of follow-up (more intensive or more specialized). Overall, screening with mammography was considered cost-effective in the age range 50-69 years in Western European and Northern American countries but not for older or younger women. Its cost-effectiveness was questionable for low-income settings and Asia. Mammography screening was more cost-effective with biennial screening compared to annual screening and single reading using computer-aided detection vs double reading. No information on the cost-effectiveness of ultrasonography was found, and there is much uncertainty on the cost-effectiveness of CBE because of methodological limitations.
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Affiliation(s)
- Olena Mandrik
- Erasmus School of Health Policy & ManagementErasmus University RotterdamRotterdamThe Netherlands
- Health Economic and Decision Science (HEDS)School of Health and Related Research (ScHARR), The University of SheffieldSheffieldUK
- The section of Early Detection and PreventionInternational Agency for Research on CancerLyonFrance
| | - Obinna Ikechukwu Ekwunife
- Collaborative Research Group for Evidence‐Based Public HealthDepartment of Prevention and EvaluationLeibniz Institute for Prevention Research and EpidemiologyBIPS/University of BremenBremenGermany
- Department of Clinical Pharmacy and Pharmacy ManagementNnamdi Azikiwe UniversityAwkaNigeria
| | - Filip Meheus
- The section of Early Detection and PreventionInternational Agency for Research on CancerLyonFrance
| | - Johan L. (Hans) Severens
- Erasmus School of Health Policy & ManagementErasmus University RotterdamRotterdamThe Netherlands
- Institute for Medical Technology Assessment (iMTA)Erasmus University RotterdamRotterdamThe Netherlands
| | - Stefan Lhachimi
- Department of Clinical Pharmacy and Pharmacy ManagementNnamdi Azikiwe UniversityAwkaNigeria
- Institute for Public Health and Nursing Research—IPPHealth Sciences BremenUniversity of BremenBremenGermany
| | - Carin A. Uyl‐de Groot
- Erasmus School of Health Policy & ManagementErasmus University RotterdamRotterdamThe Netherlands
- Institute for Medical Technology Assessment (iMTA)Erasmus University RotterdamRotterdamThe Netherlands
| | - Raul Murillo
- The section of Early Detection and PreventionInternational Agency for Research on CancerLyonFrance
- Centro Javeriano de OncologíaHospital Universitario San IgnacioBogotáColombia
- Faculty of MedicinePontificia Universidad JaverianaBogotáColombia
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29
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Mandrik O, Zielonke N, Meheus F, Severens J(H, Guha N, Herrero Acosta R, Murillo R. Systematic reviews as a 'lens of evidence': Determinants of benefits and harms of breast cancer screening. Int J Cancer 2019; 145:994-1006. [PMID: 30762235 PMCID: PMC6619055 DOI: 10.1002/ijc.32211] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 01/17/2019] [Accepted: 01/29/2019] [Indexed: 12/14/2022]
Abstract
This systematic review, stimulated by inconsistency in secondary evidence, reports the benefits and harms of breast cancer (BC) screening and their determinants according to systematic reviews. A systematic search, which identified 9,976 abstracts, led to the inclusion of 58 reviews. BC mortality reduction with screening mammography was 15-25% in trials and 28-56% in observational studies in all age groups, and the risk of stage III+ cancers was reduced for women older than 49 years. Overdiagnosis due to mammography was 1-60% in trials and 1-12% in studies with a low risk of bias, and cumulative false-positive rates were lower with biennial than annual screening (3-17% vs 0.01-41%). There is no consistency in the reviews' conclusions about the magnitude of BC mortality reduction among women younger than 50 years or older than 69 years, or determinants of benefits and harms of mammography, including the type of mammography (digital vs screen-film), the number of views and the screening interval. Similarly, there was no solid evidence on determinants of benefits and harms or BC mortality reduction with screening by ultrasonography or clinical breast examination (sensitivity ranges, 54-84% and 47-69%, respectively), and strong evidence of unfavourable benefit-to-harm ratio with breast self-examination. The reviews' conclusions were not dependent on the quality of the reviews or publication date. Systematic reviews on mammography screening, mainly from high-income countries, systematically disagree on the interpretation of the benefit-to-harm ratio. Future reviews are unlikely to clarify the discrepancies unless new original studies are published.
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Affiliation(s)
- Olena Mandrik
- Section of Early Detection and Prevention, International Agency for Research on CancerLyonFrance
- Erasmus School of Health Policy & Management, Erasmus University RotterdamRotterdamThe Netherlands
- Health Economic and Decision Science (HEDS), School of Health and Related Research (ScHARR)The University of SheffieldSheffieldUnited Kingdom
| | - Nadine Zielonke
- Department of Public Health, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Filip Meheus
- Section of Early Detection and Prevention, International Agency for Research on CancerLyonFrance
| | - J.L. (Hans) Severens
- Erasmus School of Health Policy & Management, Erasmus University RotterdamRotterdamThe Netherlands
- Institute for Medical Technology Assessment (iMTA)Erasmus University RotterdamRotterdamThe Netherlands
| | - Neela Guha
- Section of Evidence Synthesis and ClassificationInternational Agency for Research on CancerLyonFrance
| | - Rolando Herrero Acosta
- Section of Early Detection and Prevention, International Agency for Research on CancerLyonFrance
| | - Raul Murillo
- Section of Early Detection and Prevention, International Agency for Research on CancerLyonFrance
- Centro Javeriano de Oncología – Hospital Universitario San IgnacioBogotáColombia
- Faculty of Medicine – Pontificia Universidad JaverianaBogotáColombia
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Sánchez G, Herrero R, Ferruelo A, Murillo R, Douhal Y, Lorente J. Microrna 155-3P modulates the FASL-mediated inflammation in human alveolar epithelial cells in vitro. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1204] [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: 11/27/2022]
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Vale DB, Sauvaget C, Murillo R, Muwonge R, Zeferino LC, Sankaranarayanan R. Correlation of Cervical Cancer Mortality with Fertility, Access to Health Care and Socioeconomic Indicators. Rev Bras Ginecol Obstet 2019; 41:249-255. [PMID: 30912091 PMCID: PMC10309279 DOI: 10.1055/s-0039-1683859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/06/2019] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE The present study aimed to examine which development indicators are correlated with cervical cancer (CC) mortality rates in Brazil. METHODS This was an ecological study that correlated mortality rates and indicators, such as human development index (HDI), gross domestic product (GDP) per capita, illiteracy rate, fertility rate, screening coverage, proportion of private health insurance use, density of physicians, and density of radiotherapy centers. The mortality rates were obtained from the Brazilian national registry, while the indicators were based on official reports from the Ministry of Health. Univariate and multivariate linear regression was used. RESULTS Among the states of Brazil, the average age-specific CC mortality rate from 2008 to 2012 varied from 4.6 to 22.9 per 100,000 women/year. In the univariate analysis, HDI, proportion of private health insurance use, density of physicians, and density of radiotherapy centers were inversely correlated with the mortality rates. Fertility rate was positively correlated with the mortality rates. In the multivariate analysis, only fertility rate was significantly associated with the CC mortality rate (coefficient of correlation: 9.38; 95% confidence interval [CI]: 5.16-13.59). CONCLUSION A decrease in the fertility rate, as expected when the level of development of the regions increases, is related to a decrease in the mortality rate of CC. The results of the present study can help to better monitor the quality assessment of CC programs both among and within countries.
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Affiliation(s)
- Diama Bhadra Vale
- International Agency for Research on Cancer, Section of Early Detection and Prevention, Lyon, France
- Department of Tocoginecology, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Catherine Sauvaget
- International Agency for Research on Cancer, Section of Early Detection and Prevention, Lyon, France
| | - Raul Murillo
- International Agency for Research on Cancer, Section of Early Detection and Prevention, Lyon, France
| | - Richard Muwonge
- International Agency for Research on Cancer, Section of Early Detection and Prevention, Lyon, France
| | - Luiz Carlos Zeferino
- Department of Tocoginecology, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Robles C, Wiesner C, Martinez S, Salgado Y, Hernandez M, Lucas E, Lineros J, Romero P, Herrero R, Almonte M, Murillo R. Impact of operational factors on HPV positivity rates in an HPV-based screening study in Colombia. Int J Gynaecol Obstet 2018; 143:44-51. [PMID: 29944728 DOI: 10.1002/ijgo.12574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 06/06/2018] [Accepted: 06/25/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the effect of operational factors on the positivity rates of three HPV assays. METHODS Within the cross-sectional ESTAMPA study, women aged 30-64 years were recruited at healthcare centers from Soacha, Colombia, during 2012-2015. Cervical samples were collected for cotesting with Hybrid Capture 2 (HC2; Qiagen, Gaithersburg, MD, USA), and either Aptima (Hologic, Marlborough, MA, USA) or Cobas 4800 (Roche Diagnostics, Indianapolis, IN, USA). The effect of operational factors on assay performance was assessed using adjusted positivity rates obtained from logistic regression models. RESULTS There were 4168 women included. For samples collected in assay-specific medium, positivity rate differences were associated with the expertise of the nurse collecting the sample (P=0.014 HC2; P=0.091 Aptima) and if sample collection occurred after an initial cytology (P=0.025 HC2; P=0.033 Aptima). If PreservCyt medium (Hologic) was used, HC2 positivity differences were observed depending on the time between sample collection and processing (P=0.026) and on the laboratory technician processing the samples (P=0.003). No differences were observed for PreservCyt samples processed with Aptima or Cobas. CONCLUSION Nurse expertise, collection of previous cytology, processing time, and laboratory technician could influence HPV assay performance. Suitable quality assurance protocols for HPV-based screening programs are required. ClinicalTrials.gov: NCT01881659.
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Affiliation(s)
- Claudia Robles
- Prevention and Implementation Group, Early Detection and Prevention Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Carolina Wiesner
- Subdirección de Investigaciones y Salud Pública, Instituto Nacional de Cancerología de Colombia, Bogotá, Colombia
| | - Sandra Martinez
- Subdirección de Investigaciones y Salud Pública, Instituto Nacional de Cancerología de Colombia, Bogotá, Colombia
| | - Yuly Salgado
- Subdirección de Investigaciones y Salud Pública, Instituto Nacional de Cancerología de Colombia, Bogotá, Colombia
| | - Mariluz Hernandez
- Prevention and Implementation Group, Early Detection and Prevention Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Eric Lucas
- Prevention and Implementation Group, Early Detection and Prevention Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Johana Lineros
- Subdirección de Investigaciones y Salud Pública, Instituto Nacional de Cancerología de Colombia, Bogotá, Colombia
| | - Pilar Romero
- Subdirección de Investigaciones y Salud Pública, Instituto Nacional de Cancerología de Colombia, Bogotá, Colombia
| | - Rolando Herrero
- Prevention and Implementation Group, Early Detection and Prevention Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Maribel Almonte
- Prevention and Implementation Group, Early Detection and Prevention Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Raul Murillo
- Prevention and Implementation Group, Early Detection and Prevention Section, International Agency for Research on Cancer (IARC), Lyon, France
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
- Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
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Michel ME, Konczyk DJ, Yeung KS, Murillo R, Vivero MP, Hall AM, Zurakowski D, Adams D, Gupta A, Huang AY, Chung BHY, Warman ML. Causal somatic mutations in urine DNA from persons with the CLOVES subgroup of the PIK3CA-related overgrowth spectrum. Clin Genet 2018; 93:1075-1080. [PMID: 29231959 DOI: 10.1111/cge.13195] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 01/05/2023]
Abstract
Congenital lipomatous overgrowth with vascular, epidermal, and skeletal (CLOVES) anomalies and Klippel-Trenaunay (KTS) syndromes are caused by somatic gain-of-function mutations in PIK3CA, encoding a catalytic subunit of phosphoinositide 3-kinase. Affected tissue is needed to find mutations, as mutant alleles are not detectable in blood. Because some patients with CLOVES develop Wilms tumor, we tested urine as a source of DNA for mutation detection. We extracted DNA from the urine of 17 and 24 individuals with CLOVES and KTS, respectively, and screened 5 common PIK3CA mutation hotspots using droplet digital polymerase chain reaction. Six of 17 CLOVES participants (35%) had mutant PIK3CA alleles in urine. Among 8 individuals in whom a mutation had been previously identified in affected tissue, 4 had the same mutant allele in the urine. One study participant with CLOVES had been treated for Wilms tumor. We detected the same PIK3CA mutation in her affected tissue, urine, and tumor, indicating Wilms tumors probably arise from PIK3CA mutant cells in patients with CLOVES. No urine sample from a participant with KTS had detectable PIK3CA mutations. We suggest that urine, which has the advantage of being collected non-invasively, is useful when searching for mutations in individuals with CLOVES syndrome.
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Affiliation(s)
- M E Michel
- Department of Orthopaedic Surgery, Orthopaedic Research Laboratories, Boston Children's Hospital, Boston, Massachusetts
| | - D J Konczyk
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts
| | - K S Yeung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - R Murillo
- Department of Orthopaedic Surgery, Orthopaedic Research Laboratories, Boston Children's Hospital, Boston, Massachusetts
| | - M P Vivero
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts
| | - A M Hall
- Department of Anesthesia, Boston Children's Hospital, Boston, Massachusetts
| | - D Zurakowski
- Department of Anesthesia, Boston Children's Hospital, Boston, Massachusetts
| | - D Adams
- Division of Hematology/Oncology, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - A Gupta
- Department of Pathology and Lab Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - A Y Huang
- Department of Orthopaedic Surgery, Orthopaedic Research Laboratories, Boston Children's Hospital, Boston, Massachusetts
| | - B H Y Chung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - M L Warman
- Department of Orthopaedic Surgery, Orthopaedic Research Laboratories, Boston Children's Hospital, Boston, Massachusetts
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Leja M, Park JY, Murillo R, Liepniece-Karele I, Isajevs S, Kikuste I, Rudzite D, Krike P, Parshutin S, Polaka I, Kirsners A, Santare D, Folkmanis V, Daugule I, Plummer M, Herrero R. Multicentric randomised study of Helicobacter pylori eradication and pepsinogen testing for prevention of gastric cancer mortality: the GISTAR study. BMJ Open 2017; 7:e016999. [PMID: 28801429 PMCID: PMC5724070 DOI: 10.1136/bmjopen-2017-016999] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/14/2017] [Accepted: 06/21/2017] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Population-based eradication of Helicobacter pylori has been suggested to be cost-effective and is recommended by international guidelines. However, the potential adverse effects of widespread antibiotic use that this would entail have not been sufficiently studied. An alternative way to decrease gastric cancer mortality is by non-invasive search for precancerous lesions, in particular gastric atrophy; pepsinogen tests are the best currently available alternative. The primary objective of GISTAR is to determine whether H pylori eradication combined with pepsinogen testing reduces mortality from gastric cancer among 40-64-year-old individuals. The secondary objectives include evaluation of H pylori eradication effectiveness in gastric cancer prevention in patients with precancerous lesions and evaluation of the potential adverse events, including effects on microbiome. METHODS AND ANALYSIS Individuals are recruited from general population (50% men) in areas with high gastric cancer risk in Europe and undergo detailed lifestyle and medical history questionnaire before being randomly allocated to intervention or control groups. The intervention group undergoes H pylori testing and is offered eradication therapy if positive; in addition, pepsinogen levels are detected in plasma and those with decreased levels are referred for upper endoscopy. All participants are offered faecal occult blood testing as an incentive for study participation. Effectiveness of eradication and the spectrum of adverse events are evaluated in study subpopulations. A 35% difference in gastric cancer mortality between the groups is expected to be detectable at 90% power after 15 years if 30 000 individuals are recruited. Biological materials are biobanked for the main and ancillary studies. The study procedure and assumptions will be tested during the pilot phase. ETHICS AND DISSEMINATION The study was approved by the respective ethics committees. An independent Data Safety and Monitoring Board has been established. The findings will be published in peer-reviewed journals and presented at scientific meetings. TRIAL REGISTRATION NUMBER NCT02047994.
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Affiliation(s)
- Marcis Leja
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Department of Research, Riga East University Hospital, Riga, Latvia
- Digestive Diseases Centre GASTRO, Riga, Latvia
| | - Jin Young Park
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, France
| | - Raul Murillo
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, France
| | - Inta Liepniece-Karele
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Department of Research, Riga East University Hospital, Riga, Latvia
- Academic Histology Laboratory, Riga, Latvia
| | - Sergejs Isajevs
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Department of Research, Riga East University Hospital, Riga, Latvia
- Academic Histology Laboratory, Riga, Latvia
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Digestive Diseases Centre GASTRO, Riga, Latvia
| | - Dace Rudzite
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Department of Research, Riga East University Hospital, Riga, Latvia
| | - Petra Krike
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Sergei Parshutin
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Arnis Kirsners
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Institute of Information Technology, Riga Technical University, Riga, Latvia
| | - Daiga Santare
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
- Department of Research, Riga East University Hospital, Riga, Latvia
| | - Valdis Folkmanis
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Ilva Daugule
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Martyn Plummer
- Infection and Cancer Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Rolando Herrero
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, France
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Zamora-Avilés N, Murillo R, Lasa R, Pineda S, Figueroa JI, Bravo-Patiño A, Díaz O, Corrales JL, Martínez AM. Genetic and Biological Characterization of Four Nucleopolyhedrovirus Isolates Collected in Mexico for the Control of Spodoptera exigua (Lepidoptera: Noctuidae). J Econ Entomol 2017; 110:1465-1475. [PMID: 28499035 DOI: 10.1093/jee/tox130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Indexed: 06/07/2023]
Abstract
This study describes four multiple nucleocapsid nucleopolyhedrovirus isolates recovered from infected larvae of beet armyworm, Spodoptera exigua (Hübner) (Lepidoptera: Noctuidae), on crops in two different geographical regions of Mexico. Molecular and biological characterization was compared with characterized S. exigua multiple nucleopolyhedrovirus (SeMNPV) isolates from the United States (SeUS1 and SeUS2) and Spain (SeSP2). Restriction endonuclease analysis of viral DNA confirmed that all Mexican isolates were SeMNPV isolates, but molecular differences between the Mexican and the reference isolates were detected using PCR combined with restriction fragment length polymorphism (RFLP). Amplification of the variable region V01 combined with RFLP distinguished the two Mexican isolates, SeSLP6 and SeSIN6. BglII digestions showed that the majority of the isolates contained submolar bands, indicating the presence of genetic heterogeneity. Amplification of the variable regions V04 and V05 distinguished between American and the Spanish isolates. Biological characterization was performed against two laboratory colonies of S. exigua, one from Mexico, and another from Switzerland. Insects from the Mexican colony were less susceptible to infection than insects from Se-Swiss colony. In the Se-Mex colony, SeSP2 was the most pathogenic isolate followed by SeSIN6, although their virulence was similar to most of the isolates tested. In Se-Swiss colony, similar LD50 values were observed for the five isolates, although the virulence was higher for the SeSLP6 isolate, which also had the highest OB (occlusion body) yield. We conclude that the Mexican isolates SeSIN6 and SeSLP6 possess insecticidal traits of value for the development of biopesticides for the control of populations of S. exigua.
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Affiliation(s)
- N Zamora-Avilés
- Instituto de Investigaciones Agropecuarias y Forestales, Tarimbaro, Km 9.5 Carretera Morelia Zinapecuaro 58880, Tarímbaro, Michoacán, Mexico
| | - R Murillo
- Instituto de Agrobiotecnología, CSIC-Gobierno de Navarra, Av. Pamplona 123, Navarra 31192, Spain
- Departamento de Producción Agraria, Universidad Pública de Navarra, Navarra 31192, Mutilva Baja, Spain
| | - R Lasa
- Instituto de Ecología AC, Xalapa, 351 Carretera antigua a Coatepec, Veracruz 91070, Mexico
| | - S Pineda
- Instituto de Investigaciones Agropecuarias y Forestales, Tarimbaro, Km 9.5 Carretera Morelia Zinapecuaro 58880, Tarímbaro, Michoacán, Mexico
| | - J I Figueroa
- Instituto de Investigaciones Agropecuarias y Forestales, Tarimbaro, Km 9.5 Carretera Morelia Zinapecuaro 58880, Tarímbaro, Michoacán, Mexico
| | - A Bravo-Patiño
- Centro Multidisciplinario de estudios en Biotecnología, Tarímbaro, Km 9.5 Carretera Morelia Zinapécuaro 58880, Tarímbaro, Michoacán, Mexico
| | - O Díaz
- Facultad de Agronomía, Universidad Autónoma de San Luis Potosí, 64 Álvaro Obregón, San Luís Potosí 78000, Mexico
| | - J L Corrales
- Facultad de Agronomía, Universidad Autónoma de Sinaloa, Prolongación Josefa Ortiz de Domínguez, Sinaloa 80040, Mexico
| | - A M Martínez
- Instituto de Investigaciones Agropecuarias y Forestales, Tarimbaro, Km 9.5 Carretera Morelia Zinapecuaro 58880, Tarímbaro, Michoacán, Mexico
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Holme F, Kapambwe S, Nessa A, Basu P, Murillo R, Jeronimo J. Scaling up proven innovative cervical cancer screening strategies: Challenges and opportunities in implementation at the population level in low- and lower-middle-income countries. Int J Gynaecol Obstet 2017; 138 Suppl 1:63-68. [PMID: 28691331 DOI: 10.1002/ijgo.12185] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The problem of cervical cancer in low- and lower-middle-income countries (LLMICs) is both urgent and important, and calls for governments to move beyond pilot testing to population-based screening approaches as quickly as possible. Experiences from Zambia, Bangladesh, Guatemala, Honduras, and Nicaragua, where scale-up of evidence-based screening strategies is taking place, may help other countries plan for large-scale implementation. These countries selected screening modalities recommended by the WHO that are within budgetary constraints, improve access for women, and reduce health system bottlenecks. In addition, some common elements such as political will and government investment have facilitated action in these diverse settings. There are several challenges for continued scale-up in these countries, including maintaining trained personnel, overcoming limited follow-up and treatment capacity, and implementing quality assurance measures. Countries considering scale-up should assess their readiness and conduct careful planning, taking into consideration potential obstacles. International organizations can catalyze action by helping governments overcome initial barriers to scale-up.
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Affiliation(s)
| | - Sharon Kapambwe
- Ministry of Health of Zambia and Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Ashrafun Nessa
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Partha Basu
- International Agency for Research on Cancer, Lyon, France
| | - Raul Murillo
- Centro Javeriano de Oncologia, Hospital Universitario San Ignacio, Bogota, Colombia
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogota, Colombia
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Mandrik O, Ekwunife OI, Zielonke N, Meheus F, Severens JL, Lhachimi SK, Murillo R. What determines the effects and costs of breast cancer screening? A protocol of a systematic review of reviews. Syst Rev 2017; 6:122. [PMID: 28659183 PMCID: PMC5490169 DOI: 10.1186/s13643-017-0510-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 06/06/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Multiple reviews demonstrated high variability in effectiveness and cost-effectiveness outcomes among studies on breast cancer screening (BCS) programmes. No study to our knowledge has summarized the current evidence on determinants of effectiveness and cost-effectiveness of the most used BCS approaches or tried to explain differences in conclusions of systematic reviews on this topic. Based on published reviews, this systematic review aims to assess the degree of variability of determinants for (a) effectiveness and (b) cost-effectiveness of BCS programmes using mammography, clinical breast examination, breast self-examination, ultrasonography, or their combinations among the general population. METHODS We will perform a comprehensive systematic literature search in Cochrane, Scopus, Embase, and Medline (via Pubmed). The search will be supplemented with hand searching of references of the included reviews, with hand searching in the specialized journals, and by contacting prominent experts in the field. Additional search for grey literature will be conducted on the websites of international cancer associations and networks. Two trained research assistants will screen titles and abstracts of publications independently, with at least random 10% of all abstracts being also screened by the principal researcher. The full texts of the systematic reviews will then be screened independently by two authors, and disagreements will be solved by consensus. The included reviews will be grouped by publication year, outcomes, designs of original studies, and quality. Additionally, for reviews published since 2011, transparency in reporting will be assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for the review on determinants of effectiveness and a modified PRISMA checklist for the review on determinants for cost-effectiveness. The study will apply the Assessing the Methodological Quality of Systematic Reviews checklist to assess the methodological quality of systematic reviews. We will report the data extracted from the systematic reviews in a systematic format. Meta-meta-analysis of extracted data will be conducted when feasible. DISCUSSION This systematic review of reviews will examine the degree of variability in the effectiveness and cost-effectiveness of BCS programmes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016050764 and CRD42016050765.
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Affiliation(s)
- O. Mandrik
- Early Detection and Prevention Section, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon, France
- Institute of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands
| | - O. I. Ekwunife
- Collaborative Research Group for Evidence-Based Public Health, Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, BIPS/University of Bremen, Achterstraße 30, 28359 Bremen, Germany
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, PMB 5025, Awka, Nigeria
| | - N. Zielonke
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, ’s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - F. Meheus
- Early Detection and Prevention Section, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon, France
| | - J. L. Severens
- Institute of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands
- iMTA, Institute for Medical Technology Assessment, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands
| | - S. K. Lhachimi
- Collaborative Research Group for Evidence-Based Public Health, Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, BIPS/University of Bremen, Achterstraße 30, 28359 Bremen, Germany
- Institute for Public Health and Nursing Research—IPP, Health Sciences Bremen, University of Bremen, Grazer Straße 2, 28359 Bremen, Germany
| | - R. Murillo
- Early Detection and Prevention Section, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon, France
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Carrera 7 No 40-62, Bogota, Colombia
- Faculty of Medicine, Pontificia Universidad Javeriana, Carrera 7 No. 40 - 62, Bogotá, Colombia
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Huang J, Zagai U, Hallmans G, Nyrén O, Engstrand L, Stolzenberg-Solomon R, Duell EJ, Overvad K, Katzke VA, Kaaks R, Jenab M, Park JY, Murillo R, Trichopoulou A, Lagiou P, Bamia C, Bradbury KE, Riboli E, Aune D, Tsilidis K, Capellá G, Agudo A, Krogh V, Palli D, Panico S, Vainio EW, Tjønneland A, Olsen A, Martínez B, Redondo-Sanchez D, Chirlaque MD, Peeters PH, Regnér S, Lindkvist B, Naccarati A, Miren DI, Larrañaga N, Boutron-Ruault MC, Rebours V, Barré A, Redondo-Sanchez D, Bueno-de-Mesquita H, Ye W. Helicobacter pylori infection, chronic corpus atrophic gastritis and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: A nested case-control study. Int J Cancer 2017; 140:1727-1735. [PMID: 28032715 PMCID: PMC5930360 DOI: 10.1002/ijc.30590] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/22/2016] [Indexed: 12/11/2022]
Abstract
The association between H. pylori infection and pancreatic cancer risk remains controversial. We conducted a nested case-control study with 448 pancreatic cancer cases and their individually matched control subjects, based on the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, to determine whether there was an altered pancreatic cancer risk associated with H. pylori infection and chronic corpus atrophic gastritis. Conditional logistic regression models were applied to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs), adjusted for matching factors and other potential confounders. Our results showed that pancreatic cancer risk was neither associated with H. pylori seropositivity (OR = 0.96; 95% CI: 0.70, 1.31) nor CagA seropositivity (OR = 1.07; 95% CI: 0.77, 1.48). We also did not find any excess risk among individuals seropositive for H. pylori but seronegative for CagA, compared with the group seronegative for both antibodies (OR = 0.94; 95% CI: 0.63, 1.38). However, we found that chronic corpus atrophic gastritis was non-significantly associated with an increased pancreatic cancer risk (OR = 1.35; 95% CI: 0.77, 2.37), and although based on small numbers, the excess risk was particularly marked among individuals seronegative for both H. pylori and CagA (OR = 5.66; 95% CI: 1.59, 20.19, p value for interaction < 0.01). Our findings provided evidence supporting the null association between H. pylori infection and pancreatic cancer risk in western European populations. However, the suggested association between chronic corpus atrophic gastritis and pancreatic cancer risk warrants independent verification in future studies, and, if confirmed, further studies on the underlying mechanisms.
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Affiliation(s)
- Jiaqi Huang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Ulrika Zagai
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Göran Hallmans
- Department of Public Health and Clinical Nutrition, Umeå University, Umeå, Sweden
| | - Olof Nyrén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Lars Engstrand
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Rachael Stolzenberg-Solomon
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rockville, MD, USA
| | - Eric J Duell
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mazda Jenab
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France
| | - Jin Young Park
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France
| | - Raul Murillo
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Greece
| | - Pagona Lagiou
- Hellenic Health Foundation, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Greece
- Department of Epidemiology, Harvard School of Public Health, Boston, USA
| | - Christina Bamia
- Hellenic Health Foundation, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Greece
| | - Kathryn E Bradbury
- Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford, United Kingdom
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Gabriel Capellá
- Translational Research Laboratory, IDIBELL-Catalan Institute of Oncology, Barcelona, Spain
| | - Antonio Agudo
- Unit of Nutrition and Cancer. Cancer Epidemiology Research Program. Catalan Institute of Oncology-IDIBELL. L’Hospitalet de Llobregat, Barcelona, Spain
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, Milano, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy
| | - Salvatore Panico
- Dipartimento di medicina clinica e chirurgia Federico II, Naples, Italy
| | - Elisabete Weiderpass Vainio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research. Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | | | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Begoña Martínez
- Andalusian School of Public Health, Instituto De Investigación Biosanitaria Ibs, GRANADA, Spain
| | - Daniel Redondo-Sanchez
- Andalusian School of Public Health, Instituto De Investigación Biosanitaria Ibs, GRANADA, Spain
| | - Maria-Dolores Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Petra H. Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Sara Regnér
- Department of Surgery, Institution of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Björn Lindkvist
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Alessio Naccarati
- Molecular and Genetic Epidemiology Unit, Human Genetics Foundation, Turin, Italy
| | - Dorronsoro-Iraeta Miren
- Department of Health of the Basque Government, Public Health Division of Gipuzkoa, San Sebastian, Spain
| | - Nerea Larrañaga
- CIBER of Epidemiology and Public Health (CIBERESP), Spain
- Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Spain
| | - MC Boutron-Ruault
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805, Villejuif, France
- Université Paris Sud, UMRS 1018, F-94805, Villejuif, France
- Institut Gustave Roussy, F-94805, Villejuif, France
| | - Vinciane Rebours
- Department of Gastroenterology and Pancreatology, Beaujon Hospital, University Paris 7, Clichy, France
| | - Amélie Barré
- Université Paris Sud and Gastroenterology Unit, Hôpitaux Universitaires Paris Sud, CHU de Bicêtre, AP-HP, Le Kremlin Bicêtre, France
| | - Daniel Redondo-Sanchez
- CIBER of Epidemiology and Public Health (CIBERESP), Spain
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs, GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - H.B(as) Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
- The Medical Biobank at Umeå University, Umeå, Sweden
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Bohorquez M, Sahasrabudhe R, Criollo A, Sanabria-Salas MC, Vélez A, Castro JM, Marquez JR, Mateus G, Bolaños F, Panqueva C, Restrepo JI, Puerta JD, Murillo R, Bravo MM, Hernández G, Rios A, Prieto R, Tomlinson I, Echeverry M, Carvajal-Carmona LG. Clinical manifestations of colorectal cancer patients from a large multicenter study in Colombia. Medicine (Baltimore) 2016; 95:e4883. [PMID: 27749544 PMCID: PMC5059046 DOI: 10.1097/md.0000000000004883] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/24/2016] [Accepted: 08/24/2016] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is a major public health problem, and its incidence is rising in developing countries. However, studies characterizing CRC clinicopathological features in cases from developing countries are still lacking. The goal of this study was to evaluate clinicopathological and demographic features in one of the largest CRC studies in Latin America.The study involved over 1525 CRC cases recruited in a multicenter study in Colombia between 2005 and 2014 as part of ongoing genetic and epidemiological studies. We gathered clinicopathological data such as age at diagnosis, sex, body mass index, tobacco and alcohol consumption, family history of cancer, and tumor features including location, histological type, and stage. Statistical analyses were performed to test the association between age of onset, sex, and clinical manifestations.The average age at CRC diagnosis was 57.4 years, with 26.5% of cases having early-onset CRC (diagnosed by age 50 years). Most cases were women (53.2%; P = 0.009), 49.2% were overweight or obese, 49.1% were regular alcohol drinkers, 52% were smokers/former smokers, and 12.2% reported relatives with cancer. Most tumors in the study were located in the rectum (42.7%), were adenocarcinomas (91.5%), and had advanced stage (T3-T4, 79.8%). Comparisons by sex found that male cases were more likely to be obese (36.5% vs 31.1%; P = 0.001), less likely to have a family history of cancer (9.7% vs 15.3%; P = 0.016), and more likely to have advanced-stage tumors (83.9% vs 76.1%; P = 0.036). Comparisons by age of onset found that early-onset cases were more likely to be women (59.3% vs 51.0%; P = 0.005) and report a family history of cancer (17.4% vs 10.2%; P = 0.001).To our knowledge, our study is the largest report of clinicopathological characterization of Hispanic CRC cases, and we suggest that further studies are needed to understand CRC etiology in diverse Hispanic populations.
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Affiliation(s)
- Mabel Bohorquez
- Genome Center and Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, CA
- Grupo de Investigación Citogenética, Filogenia y Evolución de Poblaciones, Facultades de Ciencias y de Ciencias de Salud, Universidad del Tolima, Ibagué, Colombia
| | - Ruta Sahasrabudhe
- Genome Center and Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, CA
| | - Angel Criollo
- Genome Center and Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, CA
- Grupo de Investigación Citogenética, Filogenia y Evolución de Poblaciones, Facultades de Ciencias y de Ciencias de Salud, Universidad del Tolima, Ibagué, Colombia
| | | | | | | | - Juan Ricardo Marquez
- Hospital Pablo Tobón Uribe, Medellín, Colombia
- Clinica Las Américas, Medellín, Colombia
| | | | | | | | | | | | - Raul Murillo
- Instituto Nacional de Cancerología, Bogotá, DC, Colombia
| | | | | | - Angela Rios
- Patologos Asociados Tolima, Ibagué, Colombia
| | - Rodrigo Prieto
- Grupo de Investigación Citogenética, Filogenia y Evolución de Poblaciones, Facultades de Ciencias y de Ciencias de Salud, Universidad del Tolima, Ibagué, Colombia
| | - Ian Tomlinson
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Magdalena Echeverry
- Grupo de Investigación Citogenética, Filogenia y Evolución de Poblaciones, Facultades de Ciencias y de Ciencias de Salud, Universidad del Tolima, Ibagué, Colombia
| | - Luis G. Carvajal-Carmona
- Genome Center and Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, CA
- Grupo de Investigación Citogenética, Filogenia y Evolución de Poblaciones, Facultades de Ciencias y de Ciencias de Salud, Universidad del Tolima, Ibagué, Colombia
- Fundación de Genética y Genómica, Medellín, Colombia
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Vale DB, Sauvaget C, Muwonge R, Ferlay J, Zeferino LC, Murillo R, Sankaranarayanan R. Disparities in time trends of cervical cancer mortality rates in Brazil. Cancer Causes Control 2016; 27:889-96. [PMID: 27255650 DOI: 10.1007/s10552-016-0766-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 05/18/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE This study aimed to correct and describe cervical cancer mortality rates and trends by regions and age-groups in Brazil. It may help planning and implementing policies for cervical cancer control. METHODS Data from 2003 to 2012 were accessed through the centralized national mortality database. Correction of the age-specific mortality rates was done by proportional redistribution of ill-defined causes of death and deaths coded as 'uterine, part unspecified'. Annual percentage change (APC) was obtained by trend analysis (Joinpoint regression). RESULTS In the 10-year period, cancer and ill-defined causes corresponded, respectively, to 18.9 and 10.8 % of all deaths (except injuries). The proportion of ill-defined causes was reduced by more than a half in the period. The age-standardized cervical cancer mortality rate was 7.2 per 100,000 women-years after correction. The total increase in rates after corrections was 50.5 %. A significant decreasing trend in rates was observed at the national level (APC = -0.17, p < 0.001). North was the only region that did not show a decreasing significant trend (APC + 0.07, p = 0.28). Decreasing trends were restricted to age-groups over 40 years. CONCLUSIONS A consistent decreasing trend of cervical cancer mortality rates in Brazil from 2003 to 2012 was observed, although this was not consistent in all regions and restricted to older age-groups. Quality of data needs to be improved. Cancer control policies may consider the differences in access to care and the characteristics of regions to improve their efficiency.
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Affiliation(s)
- Diama Bhadra Vale
- Section of Early Detection and Prevention, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France.
- Department of Obstetrics and Gynecology, State University of Campinas, Caixa Postal 6111, Campinas, 13081-970, Brazil.
| | - Catherine Sauvaget
- Section of Early Detection and Prevention, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Richard Muwonge
- Section of Early Detection and Prevention, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Jacques Ferlay
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, France
| | - Luiz Carlos Zeferino
- Department of Obstetrics and Gynecology, State University of Campinas, Caixa Postal 6111, Campinas, 13081-970, Brazil
| | - Raul Murillo
- Section of Early Detection and Prevention, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Rengaswamy Sankaranarayanan
- Section of Early Detection and Prevention, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France
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Couñago F, Del Cerro E, Díaz-Gavela A, Marcos F, Recio M, Sanz-Rosa D, Thuissard I, Olaciregui K, Castro-Novais J, Carrascoso J, Hayoun C, Murillo R, Rodriguez-Luna J, Bueno C, Hornedo J, Perez-Carrion R, Martinez de Vega V, Mateo M. PO-0736: Tumour staging using MRI in prostate cancer: improvement of treatment decisions for radiotherapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31986-7] [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: 10/21/2022]
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Cañas Arboleda A, Alba LH, Becerra N, Murillo R, Paez N, Mosquera C, Garcia-Herreros P, Castillo JS. Eficacia y seguridad del uso de medicamentos para la cesación de la adicción al tabaco: revisión de guías de práctica clínica. Rev Salud Publica (Bogota) 2015. [DOI: 10.15446/rsap.v16n5.40762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
<p><strong>Objetivo </strong>Revisar la eficacia y seguridad de medicamentos para cesación del tabaquismo en el contexto de construcción de guías de práctica clínica (GPC).</p><p><strong>Métodos</strong> Revisión sistemática de GPC para adaptación mediante ADAPTE. Los desenlaces fueron cesación ≥6 meses y seguridad de las intervenciones. Las GPC se calificaron por pares con DELBI. Se extrajeron resultados de estudios agregativos incluidos en las guías seleccionadas.</p><p><strong>Resultados </strong>Los fármacos duplican la cesación comparados con placebo (tasas de 25,0 % hasta 27,0 % al combinarse con consejería). Los mayores incrementos en cesación se obtienen con ansiolíticos y antidepresivos (8,7% a 19,4%), y los menores con terapia de reemplazo nicotínico –TRN- (5,2% a 12,9%). La nortriptilina tiene eficacia similar al bupropion (aproximadamente 10,0 %). Con limitadas excepciones (parche e inhalador, tabletas y bupropion), las combinaciones de medicamentos no incrementan la abstinencia.</p><p><strong>Conclusiones </strong>TRN, vareniclina, bupropion y nortriptilina son eficaces para dejar de fumar. Las combinaciones de medicamentos requieren más evidencia y deberían restringirse a personas con alta dependencia o con falla terapéutica inicial. Serían deseables análisis de costo-efectividad para valorar implementación de programas en países en desarrollo.</p>
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de Vries E, Murillo R. Regarding articles about Cali Cancer Registry I. Salud Publica Mex 2015; 57:193-194. [PMID: 26302117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- Esther de Vries
- Grupo Vigilancia Epidemiológica del Cáncer, Instituto Nacional de Cancerologia, Bogotá, Colombia,
| | - Raul Murillo
- Dirección General, Instituto Nacional de Cancerologia, Bogotá, Colombia
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de Vries E, Arroyave I, Pardo C, Wiesner C, Murillo R, Forman D, Burdorf A, Avendaño M. Trends in inequalities in premature cancer mortality by educational level in Colombia, 1998-2007. J Epidemiol Community Health 2015; 69:408-15. [PMID: 25492898 PMCID: PMC4393795 DOI: 10.1136/jech-2014-204650] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 11/19/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND There is a paucity of studies on socioeconomic inequalities in cancer mortality in developing countries. We examined trends in inequalities in cancer mortality by educational attainment in Colombia during a period of epidemiological transition and rapid expansion of health insurance coverage. METHODS Population mortality data (1998-2007) were linked to census data to obtain age-standardised cancer mortality rates by educational attainment at ages 25-64 years for stomach, cervical, prostate, lung, colorectal, breast and other cancers. We used Poisson regression to model mortality by educational attainment and estimated the contribution of specific cancers to the slope index of inequality in cancer mortality. RESULTS We observed large educational inequalities in cancer mortality, particularly for cancer of the cervix (rate ratio (RR) primary vs tertiary groups=5.75, contributing 51% of cancer inequalities), stomach (RR=2.56 for males, contributing 49% of total cancer inequalities and RR=1.98 for females, contributing 14% to total cancer inequalities) and lung (RR=1.64 for males contributing 17% of total cancer inequalities and 1.32 for females contributing 5% to total cancer inequalities). Total cancer mortality rates declined faster among those with higher education, with the exception of mortality from cervical cancer, which declined more rapidly in the lower educational groups. CONCLUSIONS There are large socioeconomic inequalities in preventable cancer mortality in Colombia, which underscore the need for intensifying prevention efforts. Reduction of cervical cancer can be achieved through reducing human papilloma virus infection, early detection and improved access to treatment of preneoplastic lesions. Reinforcing antitobacco measures may be particularly important to curb inequalities in cancer mortality.
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Affiliation(s)
- Esther de Vries
- International Agency for Research on Cancer, Section of Cancer Information, Lyon, France
- Cancer Surveillance and Epidemiology group, National Cancer Institute, Bogota, Colombia
- Erasmus MC University Medical Center, Department of Public Health, Rotterdam, the Netherlands
| | - Ivan Arroyave
- Erasmus MC University Medical Center, Department of Public Health, Rotterdam, the Netherlands
- Facultad Nacional de Salud Pública de la Universidad de Antioquia, Medellin, Colombia
| | - Constanza Pardo
- Cancer Surveillance and Epidemiology group, National Cancer Institute, Bogota, Colombia
| | - Carolina Wiesner
- Cancer Surveillance and Epidemiology group, National Cancer Institute, Bogota, Colombia
| | - Raul Murillo
- Cancer Surveillance and Epidemiology group, National Cancer Institute, Bogota, Colombia
| | - David Forman
- International Agency for Research on Cancer, Section of Cancer Information, Lyon, France
| | - Alex Burdorf
- Erasmus MC University Medical Center, Department of Public Health, Rotterdam, the Netherlands
| | - Mauricio Avendaño
- Erasmus MC University Medical Center, Department of Public Health, Rotterdam, the Netherlands
- SE Health, Department of Social Policy, London School of Economics and Political Science, London, United Kingdom
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, USA
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Counago F, Recio M, Del Cerro E, Diaz A, Marcos F, Murillo R, Rodriguez J. 3T Multiparametric MRI (3T mMRI) With a Phased-Array Torso Coil in Staging of Prostate Cancer Patients (PCP) Prior to Radical Prostatectomy: Preliminary Results. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1302] [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: 10/24/2022]
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Counago F, Del Cerro E, Recio M, Murillo R, Díaz A, Marcos F, Cano R. Correlation Between Apparent Diffusion Coefficient (ADC) and Gleason Score (GS) in Prostate Cancer Patients (PCP) by Using 3.0 Tesla Multiparametric MRI (3T mMRI). Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1303] [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: 11/26/2022]
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Veses A, Aznar M, Martínez I, Martínez JD, López JM, Navarro MV, Callén MS, Murillo R, García T. Catalytic pyrolysis of wood biomass in an auger reactor using calcium-based catalysts. Bioresour Technol 2014; 162:250-258. [PMID: 24759640 DOI: 10.1016/j.biortech.2014.03.146] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 03/21/2014] [Accepted: 03/26/2014] [Indexed: 06/03/2023]
Abstract
Wood catalytic pyrolysis using calcium-based materials was studied in an auger reactor at 450°C. Two different catalysts, CaO and CaO·MgO were evaluated and upgraded bio-oils were obtained in both cases. Whilst acidity and oxygen content remarkable decrease, both pH and calorific value increase with respect to the non-catalytic test. Upgrading process was linked to the fact that calcium-based materials could not only fix the CO2-like compounds but also promoted the dehydration reactions. In addition, process simulation demonstrated that the addition of these catalysts, especially CaO, could favour the energetic integration since a lowest circulation of heat carrier between combustor and auger reactor should be needed. An energy self-sustained system was obtained where thermal energy required for biomass drying and for pyrolysis reaction was supplied by non-condensable gas and char combustion, respectively.
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Affiliation(s)
- A Veses
- Instituto de Carboquímica (ICB-CSIC), M. Luesma Castán 4, 50018 Zaragoza, Spain
| | - M Aznar
- Instituto de Carboquímica (ICB-CSIC), M. Luesma Castán 4, 50018 Zaragoza, Spain
| | - I Martínez
- Instituto de Carboquímica (ICB-CSIC), M. Luesma Castán 4, 50018 Zaragoza, Spain
| | - J D Martínez
- Instituto de Carboquímica (ICB-CSIC), M. Luesma Castán 4, 50018 Zaragoza, Spain; Grupo de Investigaciones Ambientales, Universidad Pontificia Bolivariana, Circular 1 N(o)70-01, Bloque 11, Piso 2, Medellín, Colombia
| | - J M López
- Instituto de Carboquímica (ICB-CSIC), M. Luesma Castán 4, 50018 Zaragoza, Spain
| | - M V Navarro
- Instituto de Carboquímica (ICB-CSIC), M. Luesma Castán 4, 50018 Zaragoza, Spain
| | - M S Callén
- Instituto de Carboquímica (ICB-CSIC), M. Luesma Castán 4, 50018 Zaragoza, Spain
| | - R Murillo
- Instituto de Carboquímica (ICB-CSIC), M. Luesma Castán 4, 50018 Zaragoza, Spain
| | - T García
- Instituto de Carboquímica (ICB-CSIC), M. Luesma Castán 4, 50018 Zaragoza, Spain.
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Couñago F, Recio M, Del Cerro E, Cerezo L, Díaz Gavela A, Marcos FJ, Murillo R, Rodriguez Luna JM, Thuissard IJ, Martin JLR. Role of 3.0 T multiparametric MRI in local staging in prostate cancer and clinical implications for radiation oncology. Clin Transl Oncol 2014; 16:993-9. [PMID: 24865628 DOI: 10.1007/s12094-014-1186-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 04/23/2014] [Indexed: 12/19/2022]
Abstract
PURPOSE To evaluate the accuracy of preoperative 3T multiparametric magnetic resonance imaging (3TmMRI) for local staging of prostate cancer and its influence on the decision to change the clinical target volume (CTV), total dose and hormonal therapy when treating prostate cancer patients with radiotherapy. METHODS From 2009 to 2013, 150 patients, who had confirmed prostate cancer and underwent a 3TmMRI before treatment with radical prostatectomy or radical radiation therapy, were included. Radiation therapy treatment (CTV, total dose and hormonal therapy) was initially determined on the basis of the clinical information, and radiation therapy plan was reevaluated after 3TmMRI review. The value of preoperative 3TmMRI in local staging and in the decision of radiotherapy treatment according to NCCN risk classification was analyzed. RESULTS 3TmMRI performed correct, over- and under staging in 78.7 % (37/47), 6.3 % (3/47), 14.8 % patients (7/47), respectively. 3TmMRI identified 6 cT2a, 7 cT2b, 28 cT2c, 3 cT3a, 3 cT3b tumors. At final pathology, 5 tumors were classified as pT2a, 5 as pT2b, 30 as pT2c, 4 as pT3a, 3 as pT3b. After reviewing the MRI reports, the initial radiotherapy and hormonal therapy plan was changed in 33.9 % patients (35/103). CONCLUSIONS In our group of patients, 3TmMRI has been a reliable technique providing an optimal staging for prostate cancer. Its routine use could induce important changes in radiation therapy treatments in a significant number of such patients. However, more additional studies are needed to clarify this issue.
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Affiliation(s)
- F Couñago
- Department of Radiation Oncology, Hospital Universitario Quirón Madrid, Calle Diego de Velázquez, 2, Pozuelo de Alarcón, 28223, Madrid, Spain,
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