Early Detection Of Precancerous Lesions Research Articles

A novel, noninvasive, multimodal screening test for the early detection of precancerous lesions and colorectal cancers using an artificial intelligence–based algorithm.

3627 Background: Colorectal cancer (CRC) ranks as the second leading cause of cancer-related mortality worldwide, and its incidence is increasing in younger populations. Detection of early-stage CRC and its precursor lesions, such as advanced adenomas (AA), is crucial for successful treatment and reduces CRC-related mortality. Although non-invasive methods for early detection are available and increase screening compliance, their performance with respect to detection of advanced adenomas and early-stage cancers is limited. Here, we describe a novel and non-invasive stool-based approach combining diagnostic biomarkers with an algorithm generated by machine learning/artificial intelligence (ML/AI) resulting in significantly improved diagnostic performance for the detection of not only CRC, but especially precancerous lesions like AA. Methods: Data were generated from a combined cohort of stool samples collected at 10 clinical sites in Europe (COLOFUTURE study) and 21 clinical sites in the US (eAArly DETECT study). The evaluable study cohort consists of 690 subjects, including 78 CRC, 146 AA, 147 with non-advanced adenoma (AD) and 319 normal colonoscopy negative control (NC) subjects (49% female, 51% male, average age 61.8 years). Results were compared with colonoscopy and pathology findings to determine sensitivity and specificity for detection of early-stage CRC and AA vs. AD and NC. Nucleic acids were extracted from stabilized stool samples using a silica bead-based extraction method. Expression of mRNA biomarkers was analyzed utilizing Real-Time PCR. Human hemoglobin was quantified using FIT. The Emerge Quantitative Evolution ML/AI platform was leveraged to develop classifiers capable of distinguishing CRC and AA from AD and NC. Results: Applying the combined approach of non-invasive diagnostic testing with an AI/ML generated algorithm, the sensitivity for detection of CRC overall was 92.3%. In addition, this method enabled AA detection with a sensitivity of 82.2%. Specificity turned out to be 90.1 % (AD+NC). Conclusions: This innovative, non-invasive, multimodal screening strategy based on self-collected stool samples which combines mRNA expression patterns and FIT analysis with an AI/ML-generated algorithm represents a substantial improvement in the effectiveness of non-invasive CRC screening. Such improvements in usability and performance leading to reliable detection of early-stage CRC and precursor lesions, such as advanced adenomas, are required for wide-spread availability and adaption of non-invasive screening tests to accepted clinically relevant usage and to prevent the development of CRC effectively.

Multi-scale window transformer for cervical cytopathology image recognition

Cervical cancer is a major global health issue, particularly in developing countries where access to healthcare is limited. Early detection of pre-cancerous lesions is crucial for successful treatment and reducing mortality rates. However, traditional screening and diagnostic processes require cytopathology doctors to manually interpret a huge number of cells, which is time-consuming, costly, and prone to human experiences. In this paper, we propose a Multi-scale Window Transformer (MWT) for cervical cytopathology image recognition. We design multi-scale window multi-head self-attention (MW-MSA) to simultaneously integrate cell features of different scales. Small window self-attention is used to extract local cell detail features, and large window self-attention aims to integrate features from smaller-scale window attention to achieve window-to-window information interaction. Our design enables long-range feature integration but avoids whole image self-attention (SA) in ViT or twice local window SA in Swin Transformer. We find convolutional feed-forward networks (CFFN) are more efficient than original MLP-based FFN for representing cytopathology images. Our overall model adopts a pyramid architecture. We establish two multi-center cervical cell classification datasets of two-category 192,123 images and four-category 174,138 images. Extensive experiments demonstrate that our MWT outperforms state-of-the-art general classification networks and specialized classifiers for cytopathology images in the internal and external test sets. The results on large-scale datasets prove the effectiveness and generalization of our proposed model. Our work provides a reliable cytopathology image recognition method and helps establish computer-aided screening for cervical cancer. Our code is available at https://github.com/nmyz669/MWT, and our web service tool can be accessed at https://huggingface.co/spaces/nmyz/MWTdemo.

Association between non-healing precancerous oral lesions and ulcers with tobacco smoking: A population-based study

BackgroundThis study aims to identify early detection of precancerous lesions amongst high-risk individuals (motor park workers). Though anecdotal evidence suggests they are high users of alcohol, marijuana, and cigarette smoking which are prominent risk factors for the occurrence of oral cancers the occurrence of precancerous lesions in this group has not been determined. MethodThis was a prospective cross-sectional study of a target population of motor park workers (40 years and above). Participants were selected from motor parks in Lagos. All participants had an examination of oral mucosa done for pre-cancerous or cancerous lesions. All suspected mucosa were stained with toluidine blue. All positively stained mucosa were repeated after 1 week for confirmation blue for suspicious cases. Positive cases were biopsied and histology was determined. ResultA total of 453 participants completed the survey. The mean age of participants was 39.4 years (SD: 12.5), 52.8 % were male, while 47.2 % were female. A majority of ever and current smokers did not have oral ulcers, and all the participants with oral ulcers did not indicate a history of smoking. a history of ever-smoking was significantly associated with higher odds of oral lesions in both bivariate (OR: 4.58; 95 % CI: 2.04,10.29; p:<0.001) and multivariate models (OR:2.76). ConclusionSmoking was significantly associated with oral pre-cancerous lesions in this study.

PAP-test: Possibilities and Limitations

Cervical cancer (CC) progresses slowly, and the cytological screening increases the likelihood of early detection of precancerous lesions. Cytology of the cervix is one of the primary methods of effective CC diagnosis, which, thanks to early detection and timely treatment, leads to a stable decrease in morbidity and mortality from invasive CC. The results of many studies have shown that the specificity of the conventional Pap smear test is approximately 80–100%, its sensitivity ranges from 30% to 80%, and the rate of inadequacy of this method is from 5% to 25%. With traditional smear preparation, only a small percentage of collected cells end up on the slide, while abnormal cells may be discarded and not analyzed. When viewing the slide, cells that have dried and clumped together may interfere with the visualization of atypical cells. To overcome these limitations, in 1996, as an alternative to the traditional Pap test, liquid cytology was presented – the technology of preparing slides on which the cells are placed in a single layer. This technology outperformed the conventional Pap test with improved fixation, reduced obscuring factors, and standardized cell transfer. In liquid cytology samples are collected by fully immersing the cytobrush in a vial containing a preservative liquid, whereby the cells are preserved and fixed simultaneously, unlike conventional smears where the sample is applied to a glass slide and fixed separately. Today, two main methods of preparation based on liquid cytology are known: ThinPrep and SurePath. The results of cytology are described according to the Bethesda system. The Bethesda classification is widely accepted because it corresponds to the clinical presentation, reproduces the nature of the lesions, and is therefore treatmentoriented with a desirable follow-up procedure. The indisputable advantage of the Pap test by liquid cytology is the ability to perform both cytological and molecular studies, in particular HPV, in one sample. This capability facilitated the implementation of a two-step strategy when HPV testing is used as a triage test for ASC-US or low-grade squamous intraepithelial lesion cytology, or when cytology is used to triage HPV-positive women.

Advancements in Endoscopic Resection for Colitis-Associated Colorectal Neoplasia in Inflammatory Bowel Disease: Turning Visible into Resectable.

Patients suffering from inflammatory bowel disease (IBD) face a two to three-fold higher risk of developing colorectal cancer (CRC) compared to the general population. In recent years, significant progress has been made in comprehending the natural history of IBD-associated CRC (IBD-CRC) and refining its treatment strategies. The decreased incidence of IBD-CRC can be attributed to improved therapeutic management of inflammation, advancements in endoscopy, and early detection of precancerous lesions via surveillance programs. Advanced imaging technologies have made previously undetectable dysplasia visible in most cases, allowing for a much more precise and detailed examination of the mucosa. Additionally, new tools have facilitated the endoscopic resection (ER) of visible lesions in IBD. Particularly, the key to effectively manage colitis-associated colorectal neoplasia (CAN) is to first identify it and subsequently guarantee a complete ER in order to avoid surgery and opt for continuing surveillance. Advanced ER techniques for CAN include endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and hybrid ESD-EMR (h-ESD). This narrative review aims to consolidate the current literature on IBD-CRC, providing an overview of advanced techniques for ER of CAN in IBD, with a particular emphasis on the impact of ESD on the long-term outcomes of IBD patients.

Prevalence and predictors of cervical cancer screening among HIV-positive women in rural western Uganda: insights from the health-belief model

BackgroundWomen living with HIV are at increased risk of developing cervical cancer (CC). Screening for cancer is an important preventive strategy for the early detection of precancerous lesions and its management. There has been inadequate evidence on cervical cancer screening (CCS) practices among HIV-positive women in rural western Uganda. This study aimed to assess the prevalence and predictors of CCS among HIV-positive women, as well as knowledge and practices regarding cervical cancer screening.MethodsA cross-sectional, analytical study was conducted among HIV-positive women attending HIV care facilities located in rural settings of western Uganda. A validated and interview-based data collection form was used to capture statistics regarding demographics, HIV care, obstetric profile, health belief constructs, and knowledge and history of CCS from the participants. Bivariate and multivariate logistic regression analyses were used to correlate women’s characteristics and health beliefs toward CCS practices.ResultsThe prevalence of CCS among HIV-positive women was found to be 39.1% (95%CI: 14.0–71.7). A multivariate logistic regression analysis showed that post-secondary education attainment (AOR = 3.21; 95%CI = 2.12–7.28), four years or more lapsing after being diagnosed as HIV-positive (AOR = 2.87; 95%CI = 1.34–6.13), having more than one child (AOR = 1.87; 95%CI = 1.04–3.35), antenatal care attendance (AOR = 1.74; 95%CI = 1.02–3.43), post-natal care attendance (AOR = 3.75; 95%CI = 1.68–5.89), and having good knowledge regarding CC (AOR = 1.26; 95%CI = 1.98–3.02) were positively associated with adherence to CCS among HIV-positive women in western Uganda. Health Belief Model (HBM) constructs like the perceived risk of developing CC (AOR = 1.82; 95%CI = 1.16–2.01), worries about developing CC (AOR = 5.01; 95%CI = 4.26–8.32), believing that CC leads to death (AOR = 2.56; 95%CI = 1.64–3.56), that screening assists in early identification (AOR = 2.12; 95%CI = 1.84–3.74) and treatment (AOR = 4.63; 95%CI = 2.78–6.43) of precancerous lesions, reducing the risk of mortality (AOR = 1.84; 95%CI = 1.12–2.75), and the reassurance provided by negative test results (AOR = 2.08; 95%CI = 1.33–4.22) were positively associated with adhering to CCS. A female doctor performing the screening (AOR = 2.02; 95%CI = 1.57–3.98) as well as offering a free screening service (AOR = 3.23; 95%CI = 1.99–4.38) were significantly associated with CCS. Meanwhile, screening being painful (AOR = 0.28; 95%CI = 0.12–0.45), expensive (AOR = 0.36; 95%CI = 0.24–0.53), time-consuming (AOR = 0.30; 95%CI = 0.19–0.41), embarrassing (AOR = 0.02; 95%CI = 0.01–0.06), and the fear of positive results (AOR = 0.04; 95%CI = 0.02–0.10) were found to have a significant negative association with adhering to CCS.ConclusionsOnly one-third of HIV-positive women had undergone CCS. Variables including secondary education attainment, four years or more lapsing after being diagnosed as HIV-positive, having more than one child, antenatal care attendance, post-natal care attendance, and knowledge about CC were positively associated with CCS adherence. Educational programs should be geared towards the risk of CC, severity of cases, benefits of screening, and reducing barriers associated with screening, which can significantly improve cervical CCS among HIV-positive women. The study proposes the incorporation of free screening services and the inclusion of trained female staff in CC prevention policies to improve CCS.

Diffuse Reflectance Spectroscopy of the Oral Mucosa: In Vivo Experimental Validation of the Precancerous Lesions Early Detection Possibility.

This article is devoted to the experimental validation of the possibility of early detection of precancerous lesions in the oral mucosa in vivo using diffuse reflectance spectroscopy in the wavelength range from 360 to 1000 nm. During the study, a sample of 119 patients with precancerous lesions has been collected and analyzed. As a result of the analysis, the most informative wavelength ranges were determined, in which the maximum differences in the backscattering spectra of lesions and intact tissues were observed, methods for automatic classification of backscattering spectra of the oral mucosa were studied, sensitivity and specificity values, achievable using diffuse reflectance spectroscopy for detecting hyperkeratosis on the tongue ventrolateral mucosa surface and buccal mucosa, were evaluated. As a result of preliminary experimental studies in vivo, the possibility of automatic detection of precancerous lesions of the oral mucosa surface using diffuse reflectance spectroscopy in the wavelength range from 500 to 900 nm with an accuracy of at least 75 percent has been shown.

Inflammation-Driven Colorectal Cancer Associated with Colitis: From Pathogenesis to Changing Therapy

Patients affected by inflammatory bowel disease (IBD) have a two-fold higher risk of developing colorectal cancer (CRC) than the general population. IBD-related CRC follows a different genetic and molecular pathogenic pathway than sporadic CRC and can be considered a complication of chronic intestinal inflammation. Since inflammation is recognised as an independent risk factor for neoplastic progression, clinicians strive to modulate and control disease, often using potent therapy agents to achieve mucosal healing and decrease the risk of colorectal cancer in IBD patients. Improved therapeutic control of inflammation, combined with endoscopic advances and early detection of pre-cancerous lesions through surveillance programs, explains the lower incidence rate of IBD-related CRC. In addition, current research is increasingly focused on translating emerging and advanced knowledge in microbiome and metagenomics into personalised, early, and non-invasive CRC screening tools that guide organ-sparing therapy in IBD patients. This review aims to summarise the existing literature on IBD-associated CRC, focusing on new insights into the alteration of the intestinal barrier and the interactions with the gut microbiome as the initial promoter. In addition, the role of OMIC techniques for precision medicine and the impact of the available IBD therapeutic armamentarium on the evolution to CRC will be discussed.

Papanicolaou Smear screening in Aligarh: A Review of the Cases

ABSTRACT: Cervical cancer is the second most common cancer after breast cancer. The risk factors associated with this dreaded yet preventable cancer is age at sexual debut, parity, multiple sexual partners, use of contraceptives and smoking etc. Fortunately, the cervical cancer are preventable because of the early detection of precancerous lesions. This is made possible by the screening procedures routinely in practice such as Pap smear, visual inspection and HPV. Methodology: The study was conducted to evaluate cervical cytological abnormalities, through pap smear reported as inflammatory lesions, precancerous (CIN1/ CIN2/CIN3) and carcinoma in situ, in women who underwent pap smear screening at the hospital. Discussion and Conclusion: This was a prospective study of pap smears received in the cytopathology laboratory from January 2019 to July 2019. A total of 202 Papanicolaou smears were sent to the cytology laboratory during the 6month time period. There were 112 (55.4%) abnormal pap smears (epithelial cell abnormalities, infections and inflammatory smears). 14 (6.9%) smears were inadequate or unsatisfactory for evaluation. 89 (44%) cases had inflammatory changes whereas epithelial abnormality was seen in 23 (11%). These findings corroborate with the fact that Papanicolaou (Pap) test is an important screening tool and is a simple technique to detect precancerous cervical lesions.

Lynch syndrome cancer vaccines: A roadmap for the development of precision immunoprevention strategies.

Hereditary cancer syndromes (HCS) account for 5~10% of all cancer diagnosis. Lynch syndrome (LS) is one of the most common HCS, caused by germline mutations in the DNA mismatch repair (MMR) genes. Even with prospective cancer surveillance, LS is associated with up to 50% lifetime risk of colorectal, endometrial, and other cancers. While significant progress has been made in the timely identification of germline pathogenic variant carriers and monitoring and early detection of precancerous lesions, cancer-risk reduction strategies are still centered around endoscopic or surgical removal of neoplastic lesions and susceptible organs. Safe and effective cancer prevention strategies are critically needed to improve the life quality and longevity of LS and other HCS carriers. The era of precision oncology driven by recent technological advances in tumor molecular profiling and a better understanding of genetic risk factors has transformed cancer prevention approaches for at-risk individuals, including LS carriers. MMR deficiency leads to the accumulation of insertion and deletion mutations in microsatellites (MS), which are particularly prone to DNA polymerase slippage during DNA replication. Mutations in coding MS give rise to frameshift peptides (FSP) that are recognized by the immune system as neoantigens. Due to clonal evolution, LS tumors share a set of recurrent and predictable FSP neoantigens in the same and in different LS patients. Cancer vaccines composed of commonly recurring FSP neoantigens selected through prediction algorithms have been clinically evaluated in LS carriers and proven safe and immunogenic. Preclinically analogous FSP vaccines have been shown to elicit FSP-directed immune responses and exert tumor-preventive efficacy in murine models of LS. While the immunopreventive efficacy of "off-the-shelf" vaccines consisting of commonly recurring FSP antigens is currently investigated in LS clinical trials, the feasibility and utility of personalized FSP vaccines with individual HLA-restricted epitopes are being explored for more precise targeting. Here, we discuss recent advances in precision cancer immunoprevention approaches, emerging enabling technologies, research gaps, and implementation barriers toward clinical translation of risk-tailored prevention strategies for LS carriers. We will also discuss the feasibility and practicality of next-generation cancer vaccines that are based on personalized immunogenic epitopes for precision cancer immunoprevention.

The role of nurses in the prevention of cervical cancer: Cervical screening, an unkept promise by the majority of women in Nigeria

ABSTRACT Cervical cancer remains a major public health problem accounting for continuous female death in developing countries. Cervical cancer is the second most common cancer in women globally with an estimated number of 500,000 new cases of cervical cancer and 273,000 mortalities annually. Cervical screening is the best cancer screening test in the history of medicine and most cost-effective of all medical screening tests. The study review aimed to highlight methods of cervical cancer prevention, identify the uptake of cervical screening among women, and explain the role of nurses in uptake of cervical screening. Cervical cancer is preventable and easily treatable if it is detected at early stages, but poor information on prevention and access to screening and treatment contributes to 90% of deaths. In the developing countries such as Nigeria, a large proportion of cervical cancers are diagnosed in advanced stages, with poor rates of survival. The three main methods for preventing cervical cancer are through primary prevention (human papillomavirus vaccination and health education), secondary prevention (cervical screening, early detection of precancerous lesions, and treatment), and tertiary prevention (measures to slow the progression or recurrence, surgical removal, radiotherapy, and chemotherapy). Nurses can help improve the acceptability of this neglected promise by focusing on health education on cervical screening and vaccination in prenatal clinics and infant welfare clinics where there are more women. Inclusion of cyberspace could also serve as a successful and popular platform for this health teaching. All nurses/midwives must preach and fervently work toward the WHO 90–70–90 plan for eradicating cervical cancer.

Sociodemographic factors predicting cervical cancer screening in a peri-urban community in Ghana

Background Cervical cancer is one of the few preventable cancers and screening is critical to the early detection of pre-cancerous lesions and initiation of treatment. This study’s aim was to determine the sociodemographic predictors of cervical cancer screening uptake in a peri-urban community in Ghana. Methods A total of 392 randomly selected sexually active women aged 10–74 years participated in this cross-sectional study. Data were collected using structured interview schedules. Binary logistic regression analysis was performed to determine the predictors of cervical cancer screening (significance set at P&lt;0.05). Results Only three of the 392 participants had ever had a Pap smear test (0.8%). Women in monogamous relationships were more likely to have had a Pap smear test (P=0.001). There was a significant association between ethnicity (P=0.019), monthly family income (P=0.015) and religion (P=0.001) and having had a Pap smear test. Conclusions It is critical that interventions to increase the uptake of cervical cancer screening aim to reduce sociodemographic inequities, in order to promote women’s health.

Histopathological profile of cervical punch biopsies and risk factors associated with high-grade cervical precancerous lesions and cancer in northwest Ethiopia

Cervical cancer is an important public health problem in Ethiopia. However, the disease is not well characterized and studied in various parts of the country. This study was designed to describe the histopathological profile of cervical biopsies and to identify risk factors associated with high-grade cervical lesions and cancer (CIN2+C). A cross-sectional study was conducted at Felege Hiwot Compressive Specialized Hospital (FHCSH) between 1 March 2019 and 30 October 2021. A structured questionnaire was used to collect data on the participants' demographic, reproductive and gynecologic history. From women presented with different degrees of cervical lesions, a senior gynecologist collected cervical swabs using (Digene HC2 DNA collection device: Qiagen, Hilden, Germany) for detection of high-risk Human papillomaviruses (HR-HPV) and punch biopsy for histopathological examinations. HR-HPVs were detected using the Abbott Alinity m system following the manufacturer protocol at the Institute of Virology, Leipzig University Hospital, Germany. Collected data entered and analyzed using SPSS version 25. A logistic regression model was used for both bivariable & multivariable analysis in order to determine the association between independent variables and CIN2+C. Statistical significance was set at a p-value <0.05. In this study, 335 women were included; the mean age was at 46.5±11.4 years. Most were living in rural settings, 221(66%) and had no formal education, 259 (77.3%). More than half of the participants, 193(57.6%) were unaware of cervical cancer. The prevalence of HIV infection and previous history of cervical screening were 44(13.1%) and 93(27.8%), respectively. HR-HPVs were detected in 178(54.3%) of the participants. The majority of biopsies, 140(41.8%; 95%CI: 36.6-47.1%), were diagnosed as cervical carcinoma. Normal histology, cervicitis, cervical intraepithelial neoplasia (CIN)-1, CIN-2, and CIN-3 accounted for 74(22.1%), 30(9.0%), 40(11.9%), 12(3.6%), and 12(3.6%), respectively. High-grade lesions and cancer (CIN2+C) together accounted 164(49.0%; 95%CI: 43.6-54.2). Cervical cancer increased steadily with the age of the participants (p<0.001) in which women above the age of fifty were approximately four times more likely to develop CIN2+C than the younger ones (AOR: 3.73; 95%CI: 1.80-7.82; p<0.001). Likewise, no screening history in the last five years (AOR: 2.03; 95%CI: 1.05-3.92; p = 0.035) and being infected with HR-HPVs (AOR: 14.23; 95%CI: 7.9-25.64; p<0.001) were found significantly associated with CIN2+C. The findings of this study revealed that cervical cancer continues to be an important women's health challenge in northwest Ethiopia. Postmenopausal women, who had no screening history within a five-year period and those women who tested positive for HR-HPV need special attention. It is important to increase the awareness of women about cervical cancer and actions for early detection of precancerous lesions should be expanded.

Attitude and Perceived Barriers Among Highly Educated Women Towards Cervical Cancer Screening by Pap Smear: An Online Survey

BackgroundCervical cancer continues to pose a heavy burden on developing countries like India. Early detection of precancerous lesions via Pap smear screening can greatly avert cervical cancer deaths. However, the uptake of cervical cancer screening is poor, and several barriers exist to adequately utilizing screening services. Knowledge of women’s attitudes in the target community is essential for successfully implementing a cervical cancer screening program.AimThis study aimed to provide insight into the attitude and perceived barriers among highly educated women and determine the association between the sociodemographic characteristics and their attitude towards screening.MethodsIt was an online descriptive study using a questionnaire conducted among highly educated women. Sociodemographic details and the perceived gynecological morbidities were enquired upon. The attitude was measured on a 5-point Likert scale, while practice was assessed by response towards ever screened. Significant barriers to not undergoing cervical cancer screening and determinants of attitude towards screening were evaluated.ResultsA total of 150 women participated, with a mean age of 36.9+9.7 years. Most (85.33%) women were apparently asymptomatic. Overall, the majority (82.67%) of participants had a favorable attitude toward cervical cancer screening, but only 5.33% of women were ever screened in the past. A major impediment to adequate practice identified was that a Pap test is ‘not required.’ In addition, the women’s age, marital status, and education were found to be significantly associated with women’s attitudes towards screening.ConclusionThe study revealed that educated women do possess a favorable attitude towards cervical cancer screening. However, a major gap is still a hindrance between women’s perception and practice. This reiterates the need for a well-designed health educational program focusing on effective information, education, and communication (IEC) strategies and strengthening the national screening program by effectively incorporating it into the health system.

Comparison of HPV testing and cervical cytology in prevention of cervical cancer

Introduction and purposeThis article aims to compare two guiding methods of cervical cancer screening: cervical cytology and HPV testing. The objective is to provide information on which method is currently more relevant in the early detection of precancerous lesions. &#x0D; Material and methodThis review was mainly based on articles collected in Pubmed i years 2015-2022. The research was done by looking through keywords as follows: “cervical cancer”, “cytology”, “HPV testing”.&#x0D; ResultsAll selected studies have demonstrated that HPV testing is a more appropriate indicator for initial high-grade CIN (cervical intraepithelial neoplasia) than cytology.&#x0D; ConclusionsAccording to the cited researches, the public health system should definitely pay more attention to HPV testing as the first stage of cervical cancer screening. Moreover, it should clarify by comparing all advantages and disadvantages of methods, which further diagnostic pathway is the most effective and has the best outcomes for the patients. &#x0D; Keywordscervical cancer, cervical screening, cytology, HPV primary screening, HPV testing

Comparison of HPV testing and cervical cytology in prevention of cervical cancer

Introduction and purpose &#x0D; This article aims to compare two guiding methods of cervical cancer screening: cervical cytology and HPV testing. The objective is to provide information on which method is currently more relevant in the early detection of precancerous lesions and and therefore should be more frequently used. &#x0D; &#x0D; &#x0D; &#x0D; Materials and method &#x0D; This review was mainly based on articles from around the world collected in Pubmed in 2003-2022, medical books and websites. The research was done by looking through keywords as follows: “cervical cancer”, “cytology”, “HPV testing”. &#x0D; Results &#x0D; All selected studies have demonstrated that HPV testing is a more appropriate indicator for initial high-grade CIN (cervical intraepithelial neoplasia) than cytology. &#x0D; Conclusions &#x0D; According to the cited researches, the public health system should definitely pay more attention to HPV testing as the first stage of cervical cancer screening. Moreover, it should clarify by comparing all advantages and disadvantages of methods, which further diagnostic pathway is the most effective and has the best outcomes for the patients. &#x0D; Keywords &#x0D; cervical cancer, cervical screening, cytology, HPV primary screening, HPV testing &#x0D;

CircRNA_101277 Influences Cisplatin Resistance of Colorectal Cancer Cells by Modulating the miR-370/IL-6 Axis.

Background Colorectal cancer (CRC) is among the most prevalent malignancies globally. Early detection of precancerous lesions through routine colonoscopy has led to a dramatic reduction in CRC-related incidence and mortality among those between the ages of 50 and 70. However, in those where the disease progresses to an advanced stage, chemotherapy remains the primary available treatment option, and the associated 5-year survival rate remains low. The identification of genes associated with CRC chemoresistance would thus be a beneficial approach to identifying novel treatments for this deadly disease. Methods The expression of circRNA_101277, miR-370, and IL-6 was assessed via qRT-PCR. IL-6 levels were measured with a human IL-6 ELISA kit based on the provided protocols. CRC cellular proliferation and cisplatin IC50 values were quantified via MTT assays. Luciferase assays were used to detect circRNA_101277 and miR-370 binding sites or miR-370 and IL-6 binding sites. Results circRNA_101277 was increased in CRC tissues compared with control samples. circRNA_101277 overexpression was evident in CRC cells, and knockdown of this circRNA suppressed cellular proliferation and cisplatin resistance in these cancer cells. At a mechanistic level, circRNA_101277 was found to function by sequestering miR-370, thereby upregulating the miR-370 target gene IL-6 and promoting cisplatin resistance via this miR-370/IL-6 axis. Conclusion In summary, our data highlight circRNA_101277 as a novel driver of CRC cell cisplatin resistance that functions by sequestering miR-370 and thereby enhancing IL-6 expression. These findings suggest that this circRNA_101277/miR-370/IL-6 axis may represent a critical axis of chemoresistance in CRC that can be targeted to diagnose and/or treat this cancer.

Primary screening of cervical cancer by Pap smear in women of reproductive age group.

Cancer cervix is a major health problem responsible for causing a higher mortality rate in women worldwide; the exponential increase in such cases can be reduced by early screening of women. The cytology-based cervical screening had a higher success rate in reducing the incidence of cervical cancer. The present study aimed to evaluate the use of Pap smear screening to find cytological abnormalities and precancerous lesions. Sexually active women over 21 years of age were enrolled for the study. A detailed history was taken on the preformed proforma, and all were subjected to vaginal examination. Samples for Pap smear were taken with the help of Ayre spatula and immediately spread over a marked grease-free glass slide and dipped into 95% ethyl alcohol fixative for cytological examination. Most of the abnormality of the epithelial cells found was in the age range of 31-50 years, and most of them were multiparous. 47.92% of the women had a chief complaint of vaginal discharge, an irregular menstrual cycle in 11.07%, and abdominal pain in 7.83%, while 30.41% were asymptomatic. Women found negative for intraepithelial neoplasia were 82.94%, while 13.36% had an inflammatory smear. 0.92% atypical squamous cells of undetermined significance (ASCUS), 2.78% Low-grade squamous intraepithelial lesion (LSIL) were found, no woman had High-grade squamous intraepithelial lesion (HSIL). Pap smear is a simple, cost-effective, non-invasive, and easy to perform tool for early detection of precancerous lesions, and it is evident that every woman above the age of 25-30 years must be recommended for cervical screening.

Prevalence of Oral Precancerous Lesions in Tobacco and Areca Nut Habituated Patients in Barpeta District, Assam, India: A Cross-sectional Study

Introduction: Oral cancer has become one of the leading causes of death and disease globally as well as in India. Tobacco consumption is responsible for nearly half of all cancers in men and nearly one-fourth of cancers in women in India and more than two-third of oral cancers are directly attributable to tobacco use. Early detection of precancerous lesions and tobacco cessation activities, if conducted together can have high impact on reducing incidence of oral cancer. Aim: To study prevalence of oral precancerous lesions in tobacco and areca nut habituated patients in Barpeta district, Assam, India. Materials and Methods: The present observational, crosssectional, hospital-based study was conducted on Outpatient Department (OPD) patients of Dentistry Department of Fakhruddin Ali Ahmed Government Medical College. College, Barpeta, Assam, India, from June 2021 to June 2022. Patients with tobacco and areca nut chewing habits were selected as study participants. Total number of study participants were 404. Oral cavity screening was done to detect oral precancerous lesion. History of tobacco and areca nut chewing habits were recorded in terms of gender, age, form of tobacco, duration and frequency. Chi-square test was used for statistical analysis. Results: Prevalence of oral precancerous lesions in tobacco consuming patients was 3.46% in smoke form and 9.9% in smokeless form. Premalignant lesions had been seen predominantly in male. Among the premalignant lesions prevalence of oral leukoplakia was highest (22.27%) followed by erythroplakia (4.46%). Overall, prevalence of precancerous lesions in tobacco and areca nut habituated patient in the present study was 37.62%. The association between prevalence of oral precancerous lesion with frequency and duration of habits was statistically insignificant (χ2 =7.167, p-value=1.000). Conclusion: In the present study, prevalence of oral precancerous lesion in tobacco and areca nut consuming patients in Barpeta district was quite high. The findings from this present study can be used to design cohort study to further understand the relation between precancerous lesions in tobacco and areca nut habituated patients.

Circulating tumor DNA-based early detection of precancerous colorectal lesions using QClamp XNA-mediated real-time PCR.

The mutation status of the gene involved in early colorectal carcinogenesis and micro-invasive liquid biopsy allows detection of mutated circulating tumor DNA (ctDNA). Early detection of precancerous lesions and CRC is vital in proper treatment and hence associated to patient survival. The frequency of APC, CTNNB1, KRAS, and BRAF mutations in circulating free DNA (cfDNA) were analyzed to evaluate the performance of the mutated ctDNA in detecting polyp and adenoma using highly sensitive QClamp XNA based PCR. A total of 71 patients with low-risk adenoma or polyps were screened and there was no significant difference in the distribution of mutations gender, age, long-term medication, smoking history, alcohol drinking, and fecal occult blood. The positive predictive value (PPV) of the four genes' panel to detect low-risk adenoma and polyps was 39.44% (n = 28/71). Specifically, of all the 71 cases studied, there were 20 cases (28.2%) with APC mutations, 7 cases (9.9%) with CTNNB1 mutations, 4 cases (5.6%) with KRAS mutations, and 2 cases (2.8%) with BRAF mutations. Most mutations occurred at APC876. The four genes' panel detected by XNA-based PCR technique might be suited to efficiently and micro-invasively detect genetic alterations in cfDNA of patients with precancerous colorectal lesions.