Cervical Cancer In Young Women Research Articles

(263) Sexuality and Fertility among Young Women Treated for Cervical Cancer

Abstract Introduction Cervical cancer is the fourth cancer in women. Its incidence is particularly high in developing countries. The increase in cases among young women in low- and middle-income countries may be due to changes in sexual behaviors and an increased risk of HPV infection and the absence of vaccination programs. The mortality and morbidity rates of cervical cancer are very high if diagnosed at an advanced stage. It is a preventable Human Papilloma Virus (HPV) related cancer. Cervical cancer patients are often stigmatized because of the idea that this cancer is associated with early-onset sexuality. Furthermore, the treatments for such cancer are mutilating for women often causing definitive infertility and sexual and/or couple dysfunctions. Objective This study aims to describe the changes in sexuality and fertility among young women diagnosed and treated for cervical cancer Methods It is a monocentric cross-sectional study based on a phone survey. We included and contacted all young women (under 40) when they were diagnosed with and/or treated for cervical cancer in our institution for 11 years from January 2010 to December 2020. We excluded all patients with a history of chronic disease other than cervical cancer. The study took place from January To May 2022. We developed an 8-item questionnaire in the local dialect and used the validated translation of the Female Sexual Function Index (FSFI) to evaluate the participants' sexual function. Results We included 23 cases of cervical cancer in young women, i.e. a response rate of 4.6%. The average age of our sample was 34.7 years (±4.7). The median age of first sexual intercourse was 21.5 years [20–25.25]. The abortion rate was 2 [0.25–2.75] per participant. The median age of the first pregnancy was 21 years [21–27]. The most common symptom leading to the cancer diagnosis was post-coital metrorrhagia in 12 (52.2%) of cases. The first Pap smear led to a cervical cancer diagnosis in 13 cases (56.5%). Five patients had a tumor size ≤ 40 mm and 4 patients were metastatic at the time of the diagnosis. Eighteen patients underwent surgical treatment of whom 5 had a fertility-sparing technique. All patients got radiation. The average duration of follow-up was 5.72 years ±0.3.247. The average survival is 9.7 years (±0.9 years; 95% CI 7.9 – 11.5 years). The 3-year survival rate is 82.6%, and the 5-year survival rate is 82.6%. Five patients expressed a desire for pregnancy after the treatment, one got pregnant after 5 years. Five patients expressed that there was an impact on their sexuality after the treatment with sexual disorders with pain, in particular dyspareunia and vulvodynia, and a decrease in female desire associated with a guilty feeling. All patients had pathological FSFI scores regarding all the domains of female sexual function Conclusions Sexuality and fertility are taboo among young cervical cancer survivors. The sexual stigma of cervical cancer as a sexually transmitted disease is present in our population. Fertility-sparing surgical techniques and less sexually harmful radiation techniques are still to be perfected. Disclosure No.

USE OF COMBINED ORAL CONTRACEPTIVES AND THE RISK OF CERVICAL CANCER IN YOUNG WOMEN

The relationship between the use of combined oral contraceptives and the risk of cervical cancer in young women has been the subject of intense scrutiny in the scientific literature. This topic, which is extremely important for women's health, has sparked debates and investigations due to the prevalence of the use of these contraceptives and the significant incidence of cervical cancer in young women. Understanding this possible association is crucial to inform contraceptive practices and cervical cancer prevention strategies. Objective: To evaluate and consolidate the available evidence on the relationship between the use of combined oral contraceptives and the risk of cervical cancer in young women, using studies and articles published in the last 10 years. Methodology: strictly adhered to the PRISMA checklist, using the PubMed, Scielo and Web of Science databases to identify relevant studies. The selected descriptors were combined oral contraceptives, cervical cancer, young women, risk and association. The search covered articles published in the last 10 years. The inclusion criteria included studies that focused exclusively on young women, directly investigated the relationship between the use of combined oral contraceptives and cervical cancer, and were published in the last 10 years. On the other hand, studies with participants outside the specific age range, research that did not directly address the association in question and articles that were not fully available or did not qualify as systematic reviews or primary studies were excluded. This methodological approach provided a comprehensive and careful analysis of the existing evidence on the topic. Results: 18 articles were selected. Analysis of studies revealed a diversity of perspectives on the association between combined oral contraceptives and cervical cancer risk in young women. Key topics included possible biological mechanisms, variations in the types of contraceptives used, and the influence of confounding factors. Conclusion: Given the complexity of the data analyzed, this review highlights the need for careful approaches in interpreting the relationship between combined oral contraceptives and cervical cancer in young women. Future research is crucial to fully clarify this association and provide more precise guidance for clinical practice.

Eugen Bogdan Aburel, a pioneer of fertility sparing surgery

Eugen Bogdan Aburel was pioneer of the fertility sparing surgery in early cervical cancer in young women desiring to preserve their childbearing potential. He graduated in Romania but started specializing in obstetrics and gynecology in Paris, where he had the chance to work with the most prominent professors of the time and do research at Sorbonne, the most famous French higher education institution. Most of his discoveries date from the time he spent in Paris hospitals, proving that a good medical school can generate remarkable physicians. The fertility sparing surgery he created after returning to Romania did not have the same chance to be known and spread to the international medical world because of the Cold War isolation, Romania belonging to the Eastern Communist bloc. However, his pioneering work in this field of surgery is fully recognized today.

Frequency of post-treatment disease after excisional procedure in stage IA1 squamous cervical carcinoma – a case series

ABSTRACT Early stages of cervical cancer in young women need conservative treatments. Electrosurgical therapies (LLETZ, LEEP, SWETZ, NETZ) have been recommended for these women. However, there are recommendations to perform a second excision when the specimen margins are not free of disease. This can lead to some important complications. This article aims to verify the frequency of residual invasive or microinvasive disease after the excisional procedure in women with IA1CC. Data on women with IA1CC diagnosed between 1990 and 2022, were retrieved from medical records. Post-treatment disease was detected during a second surgical procedure or postoperative follow-up. Among the 69 included women, three (4.3 percent; CI95 percent 0–9.2) had residual microinvasive lesions, while none showed invasive disease during a second procedure or follow-up. Only the age of 37 years or more was significantly related to the presence of preinvasive or microinvasive residual lesions. Nearly 80 percent of the women who underwent a second procedure showed no residual lesions. The absence of invasive disease in a second procedure or during the follow-up of these women and the large proportion of women with no residual lesion questions the need for a new surgical procedure even when the surgical margins of the initial specimen are involved.

Cervical cancer in young women: Are there differences in demographic, histologic factors and clinical characteristics? (1114)

Cervical cancer in young women: Are there differences in demographic, histologic factors and clinical characteristics? (1114)

ASSESSMENT OF AWARENESS AND RISK FACTORS FOR CERVICAL CANCER AMONG YOUNG WOMEN IN ALMATY

Relevance: Currently, in the world, including Kazakhstan, the increasing number of new cervical cancer cases among women of reproductive age is a socio-demographic problem. The increase in cervical cancer incidence among young women, the high prevalence of human papillomavirus (HPV) infection among young sexually active women, the lack of screening programs for the early detection of cervical cancer in young women, the need to take urgent measures to increase awareness of young women about risk factors for cervical cancer and methods of prevention and determined the relevance of this study.
 The study aimed to estimate the awareness, identify risk factors for cervical cancer, and assess the state of reproductive health of young women of Almaty by questioning.
 Methods: The article presents an analytical study of the intermediate results of a survey of young women aged 18 to 32 years and living in Almaty. Participants received full information on the upcoming survey. The questionnaire collected information on socio-demographic data, awareness of cervical cancer prevention, and women’s gynecological history. The questionnaire contained 30 questions in total and took 10 minutes to complete.
 Results: Among young women in Almaty, low awareness of primary and secondary prevention of cervical cancer was revealed in all age groups. The most common risk factors for cervical cancer among young women in Almaty were an early onset of sexual activity, smoking, and hormonal contraceptive uptake.
 Conclusion: The survey showed the problem of low awareness of girls about cervical cancer and the risk factors for developing cervical cancer. Based on these data, we can state the need for educational work on these issues among young people.

ASSESSMENT OF AWARENESS AND RISK FACTORS FOR CERVICAL CANCER AMONG YOUNG WOMEN IN ALMATY

Relevance: Currently, in the world, including Kazakhstan, the increasing number of new cervical cancer cases among women of reproductive age is a socio-demographic problem. The increase in cervical cancer incidence among young women, the high prevalence of human papillomavirus (HPV) infection among young sexually active women, the lack of screening programs for the early detection of cervical cancer in young women, the need to take urgent measures to increase awareness of young women about risk factors for cervical cancer and methods of prevention and determined the relevance of this study.
 The study aimed to estimate the awareness, identify risk factors for cervical cancer, and assess the state of reproductive health of young women of Almaty by questioning.
 Methods: The article presents an analytical study of the intermediate results of a survey of young women aged 18 to 32 years and living in Almaty. Participants received full information on the upcoming survey. The questionnaire collected information on socio-demographic data, awareness of cervical cancer prevention, and women’s gynecological history. The questionnaire contained 30 questions in total and took 10 minutes to complete.
 Results: Among young women in Almaty, low awareness of primary and secondary prevention of cervical cancer was revealed in all age groups. The most common risk factors for cervical cancer among young women in Almaty were an early onset of sexual activity, smoking, and hormonal contraceptive uptake.
 Conclusion: The survey showed the problem of low awareness of girls about cervical cancer and the risk factors for developing cervical cancer. Based on these data, we can state the need for educational work on these issues among young people.

Impact of HPV mRNA types 16, 18, 45 detection on the risk of CIN3+ in young women with normal cervical cytology.

Despite a well-established cervical cancer (CC) screening program in Norway, the incidence of CC in young women is increasing, peaking at 35 years of age. 25 percent of all women diagnosed with CC had normal cytology within 3 years prior to cancer diagnosis, addressing the need to improve the screening programme to further reduce cancer incidences missed by cytology. We wanted to investigate the detection rate of CIN3+ in women 25-39 years with normal cytology by using a 3-type HPV mRNA test as a targeted quality assurance measure. The control group is women with normal cytology. During 2014-2017, samples from 13,021 women 25-39 years of age attending cervical cancer screening were analysed at Nordlandssykehuset, Bodø, Norway, including 1,896 women with normal cytology and HPV mRNA test (intervention group), and 11,125 women with cytology only (control group). The HPV mRNA testing was performed using a 3-type HPV E6/E7 mRNA test (PreTect SEE; direct genotyping 16, 18 and 45). The women were followed-up according to national guidelines throughout December 2021. Of the 13,021 women, 429 women (3.3%) had CIN3+ confirmed by biopsy in the follow-up, including 13 cases of invasive cervical cancer. Of the 1,896 women with normal cytology and HPV mRNA test (intervention group), 49 women (2.6%) had a positive test. The risks of CIN3+ among women with either a positive or negative HPV mRNA test were 28.6% (14/49) and 0.8% (14/1847). None of the women in the intervention group developed cervical cancer during follow-up. Of the 11,125 women with cytology only (control group), 712 women (6.4%) had abnormal cytology (ASC-US+). The risks of CIN3+ among women with abnormal and normal cytology were 17.7% (126/712) and 2.6% (275/10,413). By testing women 25-39 years of age with a normal cytology result using a specific 3-type HPV mRNA test, an increase in screening programme sensitivity can be achieved without an excessive additional workload. Women with normal cytology and a negative HPV mRNA test have a very low risk of cervical cancer.

The Feasibility of Large Conization as a Fertility-Sparing Treatment in Young Women with Early-Stage Cervical Cancer.

Among the cancers affecting women of all age groups, cervical cancer (CCa) is fourth most prevalent globally. Improved screening programs have aided the early detection of cervical cancer in young women seeking fertility. In this issue of Reproductive Sciences, Tsaousidis et al. retrospectively analyzed the use of large conization (LC) in 23 patients with early-stage CCa (9 stage IA and 14 stage IB). The authors chose 4 different domains to report outcomes of interest: surgical, oncological, fertility, and obstetric. Overall, the authors reported good outcomes after LC with a median follow-up of 58months. We briefly reviewed the literature for similar studies reporting on fertility-preserving treatments for CCa. In addition, a brief note on the possible role of neoadjuvant chemotherapy was added. Future research on fertility-preserving treatment must accurately report inclusion criteria to better delineate the indications for it: good surgical outcomes require good patient selection.

Successful HPV Vaccination in Adolescents with Sickle Cell Disease Following a Quality Improvement Bundle Intervention

IntroductionHuman papilloma virus (HPV) infection can cause cervical, anal, penile, vaginal, and oropharyngeal cancer. The CDC recommends HPV vaccination as a 2 or 3-dose series at <15 or ≥15 years, respectively. Completion of the vaccine series decreases rates of cervical cancer in young women by 29%(Guo, F. et al. American Journal of Preventive Medicine 2018). For this reason, focus is currently on vaccinating younger patients to optimize benefit. Historically, adolescents have had low rates of completion of the HPV vaccine series. African Americans, in particular, have significantly lower rates than whites in receiving the full series (De, P. and H. Budhwani. Public Health 2017). Vaccine hesitancy in sickle cell disease (SCD) patients exists and is exemplified by a lower uptake in teenagers with SCD compared to non-SCD counterparts (Beverung, L. et al. American Journal of Hematology 2018). However, completion of 23-pneumococcal vaccine polyvalent (PPSV-23), which is routinely administered as a series during well-child visits, has notably been high. SCD programs serve as medical homes where primary care may also be provided. With this in mind, we introduced a quality improvement (QI) intervention to improve the uptake of HPV vaccination in the adolescent SCD clinic. A bundle intervention was developed including 1) provider education about HPV vaccination importance, 2) nurse review of each adolescent's vaccine records prior to clinic visit, 3) provider notification by the nurse regarding the need for HPV during the visit, 4) discussion of the vaccine benefits with the family, 5) provision of the vaccine in the SCD clinic after parent consent, and 6) offering of MOC points as incentive to providers for project participation. We sought to evaluate the impact of the QI bundle on completion of the HPV vaccine series. We hypothesized that implementation of the QI bundle would increase the rate of completion of the HPV vaccine series among adolescents with SCD. Secondary objectives included association between completion of the HPV vaccine series and frequency of outpatient visits to the SCD clinic, quality of life (QoL), SCD-specific knowledge, completion of the PPSV-23 series, and markers of socio-economic status (SES).MethodsRetrospective data was collected using the Sickle Cell Clinical Research and Intervention Program (SCCRIP) study database (Hankins JS, et al. Pediatr Blood Cancer 2018). Patients aged 12-18 years between October 1, 2018 and December 31, 2019 with any SCD genotype and who were enrolled on the SCCRIP study were included in analysis. The following variables were extracted: age, sex, race, ethnicity, age, economic hardship index (EHI), parental education level, household income, genotype, SCD-specific knowledge, and distance to healthcare facility. The prevalence of completed HPV series, defined as 2 doses ages <15 years and 3 doses ages ≥15 years, in the 12 months prior to implementation of the bundle vaccination program (before October 1, 2018) and after implementation of program (October 2, 2018 to December 31, 2019) was calculated using Fisher's exact. Demographic characteristics and QoL were compared between patients who completed the vaccine series and those who did not.ResultsIn total, 373 patients met inclusion criteria. Their median age was 15.2 (range 12-19), 50% were female, 225 (60.3%) had HbSS/Sβ 0-thalassemia, and 114 (29.7%) had HbC/Sβ +-thalassemia. The mean SES index was 70% (±27%) and the mean QoL score 73 (±14.6). HPV vaccine completion rates increased from 31% to 56.2% after the bundle implementation (Figure 1, p<0.01). Completion of the series was associated with higher SES index, completion of the PPSV-23 series, and higher frequency of outpatient visits. There was no significant association between completion of the vaccine series and QoL, distance from healthcare facility, and disease-specific knowledge (Table 1).DiscussionPrevention of communicable diseases such as HPV is imperative in the general population. However, baseline vaccination rates in adolescents with SCD is low. A QI intervention that includes provider education and incentives, active verification of HPV vaccination status, and promotes coordinated communication between the nurse, providers, and patients effectively increased completion of the HPV vaccine series among adolescents with SCD. Continued strategies are needed to further increase the rates of vaccine completion. [Display omitted] DisclosuresHankins: Vindico Medical Education: Consultancy; Global Blood Therapeutics: Consultancy; UpToDate: Consultancy; Bluebird Bio: Consultancy.

Cervical cancer in women under 30\xa0years of age in Norway: a population-based cohort study

BackgroundWe compared women with incident cervical cancer under the age of 30 with older women with regard to stage, morphology, screening history and cervical cancer mortality in a population-based cohort study.MethodsWe included data from the Cancer Registry of Norway. Incidence rates (per 100,000 women-years) were calculated and joinpoint regression was used to analyse trends. The Nelson-Aalen cumulative hazard function for risk of cervical cancer death during a 15-year follow-up was displayed. The hazard ratios (HRs) of cervical cancer mortality with 95% confidence intervals (CIs) were derived from Cox regression models.ResultsThe incidence of cervical cancer in women under the age of 30 has almost tripled since the 1950s, with the steepest increase during 1955–80 (with an annual percentage change (APC) of 7.1% (95%CI 4.4–9.8)) and also an increase after 2004 (3.8% (95%CI -1.3–9.2)). Out of 21,160 women with cervical cancer (1953–2013), 5.3% were younger than 30 years. A lower proportion of younger women were diagnosed at more advanced stages and a slightly higher proportion were diagnosed with adenocarcinoma and adenosquamous carcinoma comparing women above 30 years. The cumulative risk of cervical cancer death was lower for patients under the age of 30. However, the difference between the age groups decreased over time. The overall adjusted HR of cervical cancer mortality was 0.69 (95% CI 0.58–0.82) in women diagnosed under the age of 30 compared to older women.ConclusionThere has been an increase in cervical cancer incidence in women under the age of 30. Cervical cancer in younger women was not more advanced at diagnosis compared to older women, and the cervical cancer mortality was lower.

Imaging to assist fertility-sparing surgery.

Cytological screening and human papilloma virus testing has led to diagnosis of cervical cancer in young women at an earlier stage. Defining the full extent of the disease within the cervix with imaging aids the decision on feasibility of fertility-sparing surgical options, such as extended cone biopsy or trachelectomy. High spatial resolution images with maximal contrast between tumour and surrounding background are achieved with T2-weighted and diffusion-weighted (DW) magnetic resonance imaging (MRI) obtained using an endovaginal receiver coil. Tumour size and volume demonstrated in this way correlates between observers and with histology and differences between MRI and histology estimates of normal endocervical canal length are not significant. For planning fertility-sparing surgery, this imaging technique facilitates the best oncological outcome while minimising subsequent obstetric risks. Parametrial invasion may be assessed on large field of view T2-weighted MRI. The fat content of the parametrium limits the utility of DW imaging in this context, because fat typically shows diffusion restriction. The use of contrast-enhanced MRI for assessing the parametrium does not provide additional benefits to the T2-weighted images and the need for an extrinsic contrast agent merely adds additional complexity and cost. For nodal assessment, 18fluorodeoxyglucose positron emission tomography-computerised tomography (18FDG PET-CT) remains the gold standard.

Advanced cervical cancer in young women: imaging study of late and very late radiation-related side effects after successful treatment by combined radiotherapy

Radical combined radiotherapy (RT) is a standard treatment for advanced cervical cancer. The aim of our study was to identify morphological late (≥6 months) and very late (≥5 years) radiation-related comorbidities on computed tomography (CT), positron emission tomography/computerized tomography (PET/CT) or magnetic resonance imaging (MRI) scans in young females who survived ≥5 years since RT and were considered as successfully treated. Secondly, we studied a rate of clinically silent radiation-related toxicities apparent on imaging scans that might influenced on future well-being of survived females. Thirdly, we analyzed reasons why patients underwent imaging scans. We included 41 subjects aged under 50 years (mean 41.8±7.2 years, median 41 years), who survived ≥5 years since RT, with at least one available imaging scan ≥3 years since RT. The mean time between RT and the last available scan was 12.3±7.9 years (median 9 years); the mean time of clinical follow-up was 15.4±7.1 years (median 14 years). Fourteen (34.1%) females underwent the first imaging scan in emergency situation and 27 (65.9%) patients due to variable chronic complaints. Grade III-V radiation-related comorbidities occurred in 19 (46.3%) females including one case of death due to radiation-induced osteosarcoma. In 14 of 19 patients, comorbidities were multiple. Four (9.8%) females suffered from life-threatening complications (grade IV): one from an uretero-arterial fistula with massive hematuria and 3 from bowel perforations. Eleven (26.8%) subjects suffered from bowel strictures with ileus development, they underwent mean 1.7±0.8 surgery (median 1.5). The mean time since RT to the first surgery for intestinal complications was 5.4±6.0 years (median 3 years), to the second 12.0±9.6 years (median 11.5 years) and to the third surgery 9.0±4.2 years (median 9 years). Late fistulas formations (vesico-recto-vaginal) were seen in 6 (14.6%) patients. Bone complications were diagnosed in 9 (22.0%) of treated females, one case of osteosarcoma included, 4 of 9 bone complications were clinically silent. In 5 (12.2%) subjects, toxicities grade III-IV first time manifested >5 years since RT, majority of them were multiple. The bowel perforation and fistulas formations were the earliest manifested grade III-IV toxicities, with median time 3 years since RT, the bone complications were the latest manifested with median time 16 years since RT. Our study is not able to bring information about the incidence of late and very late radiation related comorbidities, according to International Federation of Gynecology and Obstetrics (FIGO) recommendations patients are clinically followed only for 5 years and imaging cross-sectional scans are not recommended. However, our study shows that if females successfully treated for advanced cervical cancer report abdominal/pelvic clinical problems, it is highly probable their imaging scans will reveal late radiation related side-effects that may affect the rest of their life. It puts forward question whether females after radical RT should been regularly followed by cross-sectional imaging methods.

A case of premature onset of young cervical cancer with abnormal lipid metabolism and literature review

Cervical cancer is the most common gynecological malignancy in developing countries. Scholars at home and abroad call cervical cancer younger than 35 years old as cervical cancer in young women (referred to as young cervical cancer). In recent years, with the promotion of cervical cancer screening, the incidence of young cervical cancer has gradually increased. This case reports a 17-year-old teenager with stage IV cervical squamous cell carcinoma with human papillomavirus type 16 and 18 positive and abnormal lipid metabolism. The onset is early, the clinical symptoms are typical, the disease progresses rapidly, and the prognosis is poor. Review the patient’s family history, morbidity, sexual life history and related clinical examination indicators, and consult relevant literature to find factors related to the onset of cervical cancer, and summarize the characteristics of the case to improve clinicians’ awareness and clinical diagnosis of the disease, And at the same time discuss whether the initial screening age for special populations should be treated specially.

The Effectiveness of Education to Increase Motivation and Primary Cervical Cancer Prevention Actions

Cervical cancer is a type of malignancy found among women, with the second highest number of sufferers globally aged 15 to 44. However, the motivation for women to do cervical cancer prevention is still low. This study aimed to test the effectiveness of education on motivation and primary prevention measures for cervical cancer in young women. The research method used was an experimental design with a pre-test post-test control group design. The sampling technique used was a proportional random sampling of 150 respondents who met the inclusion criteria, 75 as the experimental group, and 75 as the control group. The statistical test used was Wilcoxon and Mann Whitney test. The Wilcoxon test results showed that the p score was 0.000 &lt;0.05, which means a significant difference in motivation and action in the experimental and control groups before and after education. Test results. Mann Whitney showed a p score was 0.000 &lt;0.05. Based on these results, it can be concluded that education effectively increases motivation and the primary prevention of cervical cancer.

Raising awareness of cervical cancer in younger women

Imogen Pinnell highlights the effect the pandemic has had on younger women accessing the care they need and reminds us of the importance of timely referral for this group

Epidemiologic characteristics of cervical cancer in young women in Korea

Objective: Cervical cancer is the fourth most common cancer among women. Especially in developing countries, it is the leading cause of death. The GDP of the Republic of Korea is the tenth largest in the world and regarded as a developed country. Since the cervical cancer screening program was started, the age-standardized rate (ASR) of cervical cancer has decreased from 18.6 per 100,000 women in 1999 to 10.8 per 100,000 women in 2016. In 2016, the screening program was expanded to women in their 20s.

Screening for cervical cancer in younger women may be an issue - A comparative study

Cervical cancer is a burning issue in our health sector. A project on cervical &amp; breast cancer screening has been running already in Bangladesh. All sexually active women of 30-years and above or those who are married for 10 years or more are included in this project. But significant numbers of women, less than 30 years of age were referred to Colposcopy clinic for evaluation. They also had high grade lesion. The purpose of this study was to identify the need for cervical cancer screening programme in younger women who are less than 30 years old. This is a comparative retrospective study conducted in 30 years old women and less than 30 years old (21-29 years) women, who were attending Colposcopy clinic for evaluation &amp; treatment in Khulna Medical College &amp; Hospital (KMCH) from January 2013 to December 2013. We analysed 235 Colposcopies in 225 women (30 years old in Group-A; less than 30 years old in Group-B) who were attending at Colposcopy clinic in Khulna Medical College Hospital in 2013. Among group A (n=90), colposcopic findings were: normal-36 (40%), CIN I-30 (33.33%), CIN II-15 (16.67%), CIN III-2 (2.22%), invasive carcinoma-3 (3.33%). Among group B (n=135), colposcopic findings were: normal-52 (38.52%), CIN I-38 (28.14%), CIN II-26 (19.25%), CIN III-3 (2.22%), invasive carcinoma-2 (1.48%). There characteristics were analysed and compared with each other. Although cervical cancer is extremely rare at younger age, there is increasing rate of younger women with high grade cervical lesion who may need treatment. It seems that these lesions have comparable behaviors as in older women. Early age of marriage is responsible for developing cervical cancer &amp; precancerous conditions. So screening should be started in earlier. Careful colposcopic assessment and evaluation before treatment remain indispensable in this regard.&#x0D; Mediscope Vol. 7, No. 2: July 2020, Page 82-88

Japanese Mothers' Intention to HPV Vaccinate Their Daughters: How Has It Changed over Time Because of the Prolonged Suspension of the Governmental Recommendation?

The trend for cervical cancer in younger women has been increasing recently in Japan. However, as a result of the suspension of governmental recommendation, Japan’s HPV (human papillomavirus) vaccination rate for girls born since 2000 has dropped sharply. We conducted an internet survey in December of 2019, 76 months after the suspension of recommendation, to verify the intention of mothers to inoculate their daughter under current circumstances and compared with our previous surveys and leaflet intervention effect. The rates of mothers who replied that they would “inoculate” were significantly higher at 9 and 23 months, but by 32 months after the suspension the rate was significantly lower (p < 0.05, p < 0.05, p < 0.05, respectively). The rates of the mothers who replied they would not inoculate were significantly lower at 9 months and 23 months, but at 76 months was significantly higher (p < 0.05, p < 0.05, p < 0.05, respectively). We found that intervention with a leaflet that could be used under the current suspension of the governmental recommendation did not increase the mothers’ intention to inoculate their daughters. A leaflet that actively encourages vaccination may increase the intent of vaccination. It is strongly recommended that the MHLW promptly resume its recommendations for HPV vaccination.

Survival from Cervical Cancer Diagnosed Aged 20-29 Years by Age at First Invitation to Screening in England: Population-Based Study.

Age at which women are first invited to attend cervical screening in England has changed twice: in 2004, women under 25 years were no longer invited; and in 2012, first invitations were sent six months earlier (at age 24.5 years). Concomitantly, a dramatic increase in screen-detected cervical cancer was observed, and their survival had not been documented. Diagnoses of invasive cervical cancer at ages 20–29 years in 2006–2016 in England were followed until the end of 2018 for deaths. We estimated 8-year overall survival (OS) by International Federation of Gynecology and Obstetrics (FIGO) stage and age at first screening invitation. Overall and relative survival for stage IA cervical cancer for women diagnosed aged 20–29 years in England (n = 1905) was excellent at 99.8% (95% confidence intervals (CI): 99.4–99.9%) and 100% (95% CI: 99.7–100.1%), respectively. OS for stage IB cervical cancer (n = 1101) was 90.4% (95% CI: 88.3–92.2%). Survival from stage IB was worse for women diagnosed age 20–24 years compared to those diagnosed 25–29 years at diagnosis (p < 0.0001), but no difference was observed by age at first invitation for screening, p = 0.8575. OS for stage II (65.5%, 95% CI: 60.2–72.0%) and stage III+ (36.6%, 95% CI 28.4–44.7%) were poorer. Survival from stage I cervical cancer in young women in England is excellent: mortality in women with stage IA cancer is akin to that of the general population regardless of age at first invitation to screening.