Higher Risk Of Cervical Cancer Research Articles

Current status and challenges in timely detection of cervical cancer in Mexico: expert consensus.

Cervical cancer is a significant public health problem in low- and middle-income countries, accounting for 85% of new cases worldwide. Due to poorly organized screening programs, cervical cancer is more likely to develop in vulnerable groups who do not initiate or rarely undergo screening. Cervical cytology and detecting high-risk human papillomavirus types are the recommended screening tools. Further, these strategies allow for accurately identifying women at a higher risk of cervical cancer and establishing screening times. New detection tools, such as novel biomarkers or automatic HPV detection in the vagina or urine, can improve screening coverage. This review aims to identify the challenges faced by detection programs and screening tools in Mexico to provide evidence-based recommendations to improve early detection programs for cervical cancer.

Evaluation of clinical usefulness of HPV-16 and HPV-18 genotyping for cervical cancer screening.

High-risk human papillomavirus (HR-HPV) infection is a leading cause of cervical cancer, of which human papillomavirus (HPV)-16 and HPV-18 account for about 70% of cases. Since HPV infection is common, it is important to focus on the HPV genotypes that pose the highest risk for effective cervical cancer screening. In this study, we evaluated the clinical usefulness of HPV-16/HPV-18 genotyping for cervical cancer screening. A total of 86,022 women aged 25 years or older was analyzed in this study. Sensitivity, specificity, positive predictive value, and negative predictive value of HPV genotyping and cytology were analyzed. In addition, we subdivided participants into two groups according to cytology results, negative for intraepithelial lesion of malignancy (NILM) and atypical squamous cells of undetermined significance (ASC-US), and analyzed absolute risk (AR) and relative risk (RR) of cervical intraepithelial neoplasia (CIN) 3 or worse according to HPV genotype. The AR of CIN 3 or worse was 77.0 times higher in HR-HPV-positive compared to HR-HPV-negative. Compared to 12 other HR-HPV-positive, the AR of CIN 3 or worse was 4.2 times higher in HPV-16 and/or HPV-18 positive. This finding was more evident in women with NILM than in women with ASC-US. The RR of CIN 3 or worse was 7.0 in women with NILM and 4.5 in women with ASC-US. Regardless of the cytology results, the risk of CIN 3 or worse was higher in HPV-16/HPV-18 than in other HR-HPV. HPV-16/HPV-18 genotyping is recommended to screen women with a high risk of cervical cancer.

Characteristics of Cervical Cancer Caused by the Human Papillomavirus 18 and Its Genetic Variations in Vietnamese Women

BackgroundThe involvement of HPV18 in cervical cancer pathogenesis, as well as its high oncogenic potential and influence on the variation of cervical cancer distribution in different geographical regions, makes assessing the characteristics of cervical cancer and its variants the basis for considering potential carcinogenic HPV18 sequence variations and vaccine strategies. MethodsA prospective study was conducted at Vietnam Central Obstetrics Hospital from January 1, 2019 to December 31, 2020. HPV18 infection was confirmed in cervical cancer patients using molecular diagnostics. Nucleotide sequences of the HPV18 E6, E7, and L1 genes were used to analyze genetic variations. The demographic, clinical, and laboratory data of the patients were collected and statistically analyzed. ResultsAmong 48 patients with HPV18-infected cervical cancer, 79.2% were between the ages of 35–54; while only 20.8% were < 35 and > 54 years old. 100% of patients have been pregnant at some point in their lives, with ≥3 pregnancies accounting for 83.3%. Patients with cervical cancer caused by HPV18 infection were predominantly in stages 0 and I, with no patients in stages II, III, or IV. A single HPV18 infection generates much more cervical cancer cases than multiple HPV18 infections. Symptoms such as lower abdomen pain, unusual anginal discharge, and vaginal bleeding were observed in both stages 0 and I; however, vaginal bleeding after sex was only detected in women with stage I cervical cancer. Cervicitis, cervical ectropion, and ulcers are reported in cervical status stages 0 and I; however, warts and ulcers were only present in stage I. Magnetic resonance imaging produces far superior outcomes than ultrasound. All cytology and pathology tests confirmed L/HSIL, SCC, AC, and CIS. On the other hand, a single HPV18 infection was associated with a significantly higher risk of L/HSIL, SCC, AC, and CIS than multiple HPV18 infections. Nulceotide sequences of the E6, E7, and L1 genes revealed 20 mutations, including three (E6), five (E7), and twelve (L1) mutations. High-frequency mutations (95.8%–100% of HPV18 samples had mutations) occur at the following positions: C287G - P61P (E6 gene), G5503A - R25Q, C5701G - P91R, C6460G - P344R, C6625G - P399R, and C6842G - P471R (L1 gene). A phylogenetic tree based on the E6/E7/L1 gene sequence revealed that 100% belonged to A lineage, with 97.9% belonging AA (Asian Amerindian - A1) and 2.1% belonging to the E (European - A5). ConclusionPatients with a single HPV18 infection have a higher risk of cervical cancer than those infected with HPV18 and other high-risk strains simultaneously. HPV18 single-infection, on the other hand, had considerably higher incidences of L/HSIL, SCC, AC, and CIS than HPV18 co-infection. The HPV18 strain that was found in Vietnam belonged to lineage A (A1 and A5), which contains several oncogene mutations.

OP81 Cost Effectiveness Of Human Papillomavirus Extended Genotyping For Cervical Cancer Screening In Singapore

IntroductionThe World Health Organization recommends the human papillomavirus (HPV) test for cervical cancer screening. HPV partial genotyping (PGT) identifies HPV16 and HPV18 individually and the 12 other high-risk HPV genotypes (hrHPV) collectively. In contrast, HPV extended genotyping (XGT) identifies six hrHPV individually (HPV16,18,31,45,51, and 52) and the other eight in three groups (HPV33/58, HPV56/59/66, and HPV35/39/68). XGT allows better risk stratification for patient management and monitoring of persistent same-genotype infections (PSGI), which convey a higher risk for cervical cancer. This study compared the cost, quality-adjusted life-years (QALYs), and resource use of XGT with PGT when used as the primary cervical cancer screening method in Singapore.MethodsA discretely integrated condition event simulation was developed for screening 500,122 women aged 30 to 69 years over five years from the health system perspective, using a three percent annual discount. For XGT, women with HPV35/39/51/56/59/66/68 and reflex cytology of atypical squamous cells of undetermined significance were recalled for a repeat screening in one year, instead of the immediate colposcopy referral that occurs with PGT. At repeat screening, colposcopy was only provided for women with PSGI on XGT. Published data from Singapore were used for inputs and supplemented with data from international literature. Deterministic and probabilistic uncertainty analyses were conducted. Scenario analysis was conducted to simulate various HPV burdens among women. XGT was cost effective when the incremental cost-effectiveness ratio (ICER) relative to PGT was below SGD100,000 (USD118,906) (gross domestic product per capita in 2021).ResultsXGT was cost effective relative to PGT (ICER SGD16,370 [USD19,465]), with fewer colposcopies (n=7,130; 19%), liquid-based cytology tests (n=6,027; 7%), and clinic consultations (n=9,787; 2%) but more HPV tests (n=2,446; 0.5%). The ICER was most sensitive to the relative cost of XGT and the cost of PGT. XGT remained cost effective in one-way sensitivity analysis in all 1,000 probabilistic uncertainty simulations and in scenario analysis with various HPV burdens.ConclusionsXGT can provide a cost effective, risk-based approach to primary cervical cancer screening, with lower resource utilization than PGT.

Correlation of cervical cancers with long-term use of hormonal oral contraceptive pills - A retrospective observational multicentric study in suburban-based medical colleges in West Bengal

Background: Hormonal oral contraceptive pills (OCP) may increase the risk of carcinoma cervix by changing the susceptibility of cervical cells to persistent infection with high-risk human papilloma virus. There is a causal and promoting association with long-term use of these pills for more than 5 years of use, and the association is diminished 10 years after last use. Aims and Objectives: In this study, retrospective data were collected to analyze the risk of association of carcinoma cervix with hormonal contraceptive pill use. Materials and Methods: Interview-based retrospective observational study to enquire about the history of hormonal OCP use and duration of intake in all diagnosed cases of cervical carcinoma attending gynecology and oncology outpatient departments over the period of 2 years in two medical colleges in suburban West Bengal. Results: Of the total 401 subjects, 119 have a history of intake of hormonal OCPs, and 198 have a history of other methods of contraception. Among the subjects, 67.58% had squamous cell carcinoma (SCC), 31.67% had adenocarcinoma of the cervix, and 0.75% had other varieties. There is no correlation between the duration of hormonal OCP use and SCC cervix (P=0.269), whereas there is a significant correlation between adenocarcinoma of the cervix and duration of intake of hormonal OCP (P=0.002). Conclusion: Studies have shown that women who have used OCPs for 5 or more years have a higher risk of cervical cancer than women who have never used oral contraceptives. This study reported a statistically significant increase in the relative risk of adenoca of the cervix but not of the SCC of the cervix, even after long-term use of hormonal OCPs.

Cervical Cancer Screening Positivity Among Women Living With HIV in CDC-PEPFAR Programs 2018-2022.

The US President's Emergency Plan for AIDS Relief aims to address the higher risk of cervical cancer among women living with HIV by offering high-quality screening services in the highest burden regions of the world. We analyzed the US President's Emergency Plan for AIDS Relief Monitoring, Evaluation, and Reporting data from Centers for Disease Control and Prevention-supported sites in 13 countries in sub-Saharan Africa for women living with HIV aged older than 15 years who accessed cervical cancer screening services (mostly visual inspection, with ablative or excisional treatment offered for precancerous lesions), April 2018-March 2022. We calculated the positivity by age, country, and clinical visit type (first lifetime screen or routine rescreening). We fitted negative binomial random coefficient models of log-linear trends in time to estimate the probabilities of testing positive and any temporal trends in positivity. Among the 2.8 million completed cancer screens, 5.4% identified precancerous lesions, and 0.8% were positive for suspected invasive cervical cancers (6.1% overall). The positivity rates declined over the study period among those women screening for cervical cancer for the first time and among those women presenting to antiretroviral therapy clinics for routine rescreening. These positivity rates are lower than expectations set by the published literature. Further research is needed to determine whether these lower rates are attributable to the high level of consistent antiretroviral therapy use among these populations, and systematic program monitoring and quality assurance activities are essential to ensure women living with HIV have access to the highest possible quality prevention services.

Occupational health hazards of bidi workers and their families in India: a scoping review

BackgroundBidi workers and their families are exposed to harmful substances during bidi rolling, thereby jeopardising their health. We aimed to assess existing evidence on health conditions of bidi workers and...

Investigation of Preventive Practices and Perception of Cervical Cancer Among Female Students at the Polytechnic in Ibadan, Oyo State

The objective of this study is to determine the perception of female students of the polytechnic of Ibadan, Oyo State, towards cervical cancer and preventive. A cross-sectional study design was used to determine the above objective. The survey included 429 female students who lived on the Polytechnic Ibadan campus. A systematic sampling technique was used to choose 210 rooms out of a total of 420 rooms, and all of the selected rooms' occupants were questioned under the premise that there were two people in each room. Data were gathered using a self-administered questionnaire that had been pretested. Respondents with one or more risk factors were classified as being at a higher risk for cervical cancer and those with no risk factors as being at a lower risk. Data was analyzed using descriptive statistics and Chi square test at p&lt;0.05. Mean age of respondents was 24.2±3.7 years. More than half (60.3%) had good knowledge about cervical cancer and 55.1% had a good perception of cervical cancer. The identified risk factors were sexual debut before the age of 18 years (25.1%) multiple sexual partnering (11.6%), unprotected sexual intercourse (59.2%) and positive family history of cervical cancer (2.2%). Majority of the respondents (96.9%) were at a higher risk for developing cervical cancer. Few respondents (8.0%) had ever heard of the pap smear test and the major sources of information were the internet (33.3%) and hospital (25%). The uptake of pap smear test was low (1.8%). Majority of the respondents (71.9%) were not aware of where the pap smear test could be done. Only 4.7% were willing to receive the human papilloma virus (HPV) vaccine, while 5.1% were willing to do a pap smear test. The major reasons cited for not wanting to do the pap smear test was lack of perceived need for the test (13.4%) and financial constraint (1.5%). Respondents who were 25 years and below and single were more likely to have a good perception of cervical cancer. Those aged &lt;30 years (OR 1.39, 95% CI 0.34-5.66), single (OR 1.07, 95% CI 0.45-2.50), those from faculty of science (OR 1.22, 95% CI 0.57-2.58) and those that had low risk score (OR 2.66, 95% CI 0.54-12.98) were likely to have a good perception of cervical cancer. Even though respondents had a fair amount of awareness about cervical cancer, they nevertheless exhibited significant behavioral risk factors for the condition. The pap smear test had very poor awareness and uptake. Therefore, it is necessary to develop health communication initiatives that would motivate tertiary students to apply their learning to prevent cervical cancer

Investigation of Preventive Practices and Perception of Cervical Cancer Among Female Students at the Polytechnic In Ibadan, Oyo State

The objective of this study is to determine the perception of female students of the polytechnic of Ibadan, Oyo State, towards cervical cancer and preventive. A cross-sectional study design was used to determine the above objective. The survey included 429 female students who lived on the Polytechnic Ibadan campus. A systematic sampling technique was used to choose 210 rooms out of a total of 420 rooms, and all of the selected rooms' occupants were questioned under the premise that there were two people in each room. Data were gathered using a self-administered questionnaire that had been pretested. Respondents with one or more risk factors were classified as being at a higher risk for cervical cancer and those with no risk factors as being at a lower risk. Data was analyzed using descriptive statistics and Chi square test at p&lt;0.05. Mean age of respondents was 24.2±3.7 years. More than half (60.3%) had good knowledge about cervical cancer and 55.1% had a good perception of cervical cancer. The identified risk factors were sexual debut before the age of 18 years (25.1%) multiple sexual partnering (11.6%), unprotected sexual intercourse (59.2%) and positive family history of cervical cancer (2.2%). Majority of the respondents (96.9%) were at a higher risk for developing cervical cancer. Few respondents (8.0%) had ever heard of the pap smear test and the major sources of information were the internet (33.3%) and hospital (25%). The uptake of pap smear test was low (1.8%). Majority of the respondents (71.9%) were not aware of where the pap smear test could be done. Only 4.7% were willing to receive the human papilloma virus (HPV) vaccine, while 5.1% were willing to do a pap smear test. The major reasons cited for not wanting to do the pap smear test was lack of perceived need for the test (13.4%) and financial constraint (1.5%). Respondents who were 25 years and below and single were more likely to have a good perception of cervical cancer. Those aged &lt;30 years (OR 1.39, 95% CI 0.34-5.66), single (OR 1.07, 95% CI 0.45-2.50), those from faculty of science (OR 1.22, 95% CI 0.57-2.58) and those that had low risk score (OR 2.66, 95% CI 0.54-12.98) were likely to have a good perception of cervical cancer. Even though respondents had a fair amount of awareness about cervical cancer, they nevertheless exhibited significant behavioral risk factors for the condition. The pap smear test had very poor awareness and uptake. Therefore, it is necessary to develop health communication initiatives that would motivate tertiary students to apply their learning to prevent cervical cancer.

HUMAN PAPILLOMA VIRUS - ORAL INFECTION –A REVIEW

Human papilloma virus is the most common sexually transmitted infection and persistent HPV is associated with high risk of cervical cancer, genital warts and also oral mucosa. The benign clinical manifestation of HPV infection are oral papilloma / condyloma and focal epithelial hyperplasia. The association between Human papilloma virus [HPV] types and oral lesions have been shown in many studies. The purpose of the study is to highlight the persistent infection of HPV ( which tend to become malignant), transmission of HPV, oral signs and symptoms of infection and their treatment.

Questionnaire survey on the prevention and development of cervical cancer in patients with systemic lupus erythematosus in Japan.

The aim is to evaluate the prevention and development of cervical cancer in systemic lupus erythematosus (SLE) patients in Japan and its background based on a questionnaire survey. The questionnaire was handed to 460 adult female SLE patients at 12 medical institutions. The participants were grouped by age, and data related to their human papillomavirus vaccination status, age at first coitus, cervical cancer screening, and diagnosis of cervical cancer were analysed. A total of 320 responses were received. Patients aged 35-54 years included a higher proportion of patients whose age at first coitus was <20 years. This group also showed a higher rate of cervical cancer/dysplasia. Only nine patients had a human papillomavirus vaccination history. Adequate frequency of cervical cancer screening was slightly higher (52.1%) among SLE patients than in the Japanese general population. However, 23% of the patients had never undergone examination, primarily because of a feeling of troublesome. The incidence of cervical cancer was significantly higher among SLE patients. One reason for this may be associated with the use of immunosuppressants, although the difference was not significant. SLE patients are at a higher risk of cervical cancer and dysplasia. Rheumatologists should proactively recommend vaccination and screening examinations for SLE female patients.

HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the Literature.

Identifying and reaching women at higher risk for cervical cancer is all-important for achieving the ambitious endpoints set in 2020 by the WHO for global cervical cancer control by 2030. HPV-based (vaginal) self-sampling (SS) represents a cost-effective screening strategy, which has been successfully implemented during the last decade both in affluent and constrained settings. Among other advantages, SS strategies offer convenience, diminished costs, flexibility to obtain a sample in the office or home, avoiding a pelvic exam and uncomfortable appointment with a healthcare professional, as well as social and cultural acceptability. SS implementation has been globally boosted during the COVID-19 pandemic. In pragmatic terms, social distancing, local lockdowns, discontinuation of clinics and reallocation of human and financial resources challenged established clinician-based screening; self-collection strategies apparently surpassed most obstacles, representing a viable and flexible alternative. With time, sufficient reassuring data has accumulated regarding specially designed SS devices, aspects of sample preparation, transport and storage and, importantly, optimization of validated PCR-based HPV testing platforms for self-collected specimens. Suboptimal rates of clinical follow-up post-SS screening, as well as overtreatment with reliance solely on molecular assays, have both been documented and remain concerning. Therefore, effective strategies are still required to ensure linkage to follow-up testing and management following positive SS results by trained health professionals with knowledge of HPV biology and management algorithms. Because of the prolonged SS screening intervals, implementation data are limited regarding subsequent screening rounds of SS-screened individuals; however, these are accumulating gradually. With further refinement of assays and validation of novel biomarkers in self-collected samples, there is a clear potential for increasing SS accuracy and PPV. The potential differentiation of self-collection protocols for vaccinated versus non-vaccinated individuals also represents an open issue. In conclusion, HPV-based self-collection techniques can effectively address limited uptake alongside other conventional cervical screening drawbacks; however, assays, logistics and infrastructures need further optimization to increase the efficacy, effectiveness and cost-effectiveness of SS approaches.

Risk Analysis Stratification of CIN 2+ Development in a Cohort of Women Living with HIV with Negative Pap Smear and HR-HPV Test during a Long-Term Follow-Up.

Women living with Human Immunodeficiency Virus are at higher risk of cervical cancer and precancer compared to women without HIV infection. The aim of the study is to evaluate the risk factors for the development of CIN2+ in a cohort of WLWH with negative colposcopy and cytology during a long follow-up period. We enrolled, in a multicentric retrospective cohort study, WLWH who attended the colposcopic services from 1999 to 2019. Patients with a normal Pap smear, a negative HR-HPV test, and at least one year of follow-up were considered for the anlysis. The five-year cumulative incidence of histologically confirmed HSIL was 8.3% (95% CI = 2.6-13.6) among subjects with a CD4+ cell count of <200 cells/µL at any visit and 2.1% (95% CI = 0.7-3.4, p = 0.001) in women with a CD4+ cell count of persistently >200 cells/µL. In women with persistent HR-HPV infection, the five-year cumulative incidence of CIN 2+ was 6% (95% CI = 1.6-10.2) versus 2% (95% CI = 0.4-3.6, p = 0.012) in women without HPV infection. An HIV viremia of >200 copies/mL, a CD4+ cell count of <200 cells/µL, persistent HR-HPV infection, and smoking ≥10 cigarettes/day were all independent and statistically significant risk factors associated with the development of CIN2+ during follow-up. WLWH with good immune status and negative Pap smear and HR-HPV test have a low risk for CIN2+.

Pregnancy Loss in Relation to the Risks of Female-Specific Cancers in a Population-Based Cohort and Mendelian Randomization Study - China, 2004-2017.

Limited evidence exists regarding the relationship between pregnancy loss and female-specific cancers within the Chinese population from prospective cohort studies. Terminations were associated with a 13% lower risk of endometrial cancer, whereas stillbirths were related to an 18% higher risk of cervical cancer. Rural residents with a history of pregnancy loss experienced a 19% and 38% increased risk of breast and cervical cancers, respectively, compared to their urban counterparts. Moreover, a positive graded relationship between live births and pregnancy loss on cervical cancer was observed. This study has significant implications for identifying women at an increased risk for breast and genital cancers and contributes to the development of effective public health strategies for female cancer prevention. Future research on reproductive history, particularly in rural areas, should be given priority in efforts to improve female cancer screening and early detection.

Impact of the Mobile Game FightHPV on Cervical Cancer Screening Attendance: Retrospective Cohort Study

The wide availability of mobile phones has made it easy to disseminate health-related information and make it accessible. With gamification, mobile apps can nudge people to make informed health choices, including attending cervical cancer screening. This matched retrospective cohort study examined the association between exposure to the FightHPV mobile app gamified educational content and having a cervical exam in the following year. Women aged 20 to 69 years who signed an electronic consent form after downloading the FightHPV app in 2017 (intervention group) were matched 1:6 with women of the same age and with the same screening history (reference group) in 2015. To estimate the impact of exposure to the FightHPV app, we estimated cumulative incidence and hazard ratios (HRs) with 95% CIs. We used data from the Norwegian Cervical Cancer Screening Program database and Statistics Norway to determine screening participation and outcomes, respectively. We matched 3860 women in the control group to 658 women in the intervention group; 6 months after enrollment, 29.6% (195/658) of the women in the intervention group and 15.21% (587/3860) of those in the reference group underwent a cervical exam (P<.01). Women exposed to the FightHPV app were 2 times more likely to attend screening (adjusted HR 2.3, 95% CI 2.0-2.7), during which they were 13 times more likely to be diagnosed with high-grade abnormality (adjusted HR 12.7, 95% CI 5.0-32.5) than the women in the reference group. Exposure to the FightHPV app significantly increased cervical cancer screening attendance across the various analyses and improved detection of women with high risk for cervical cancer. For the first time, we demonstrated the effectiveness of gamification combined with mobile technology in cancer prevention by empowering women to make active health-related decisions. Gamification can significantly improve the understanding of complicated scientific concepts behind interventions and increase the acceptance of proposed cancer control measures.

Estimating the effect of HIV on cervical cancer elimination in South Africa: Comparative modelling of the impact of vaccination and screening.

In 2020, the World Health Organization (WHO) launched its initiative to eliminate cervical cancer as a public health problem. To inform global efforts for countries with high HIV and cervical cancer burden, we assessed the impact of human papillomavirus (HPV) vaccination and cervical cancer screening and treatment in South Africa, on cervical cancer and the potential for achieving elimination before 2120, considering faster HPV disease progression and higher cervical cancer risk among women living with HIV(WLHIV) and HIV interventions. Three independent transmission-dynamic models simulating HIV and HPV infections and disease progression were used to predict the impact on cervical cancer incidence of three scenarios for all women: 1) girls' vaccination (9-14 years old), 2) girls' vaccination plus 1 lifetime cervical screen (at 35 years), and 3) girls' vaccination plus 2 lifetime cervical screens (at 35 and 45 years) and three enhanced scenarios for WLHIV: 4) vaccination of young WLHIV aged 15-24 years, 5) three-yearly cervical screening of WLHIV aged 15-49 years, or 6) both. Vaccination assumed 90% coverage and 100% lifetime protection with the nonavalent vaccine (against HPV-16/18/31/33/45/52/58). Cervical cancer screening assumed HPV testing with uptake increasing from 45% (2023), 70% (2030) to 90% (2045+). We also assumed that UNAIDS 90-90-90 HIV treatment and 70% male circumcision targets are reached by 2030. We examined three elimination thresholds: age-standardised cervical cancer incidence rates below 4 or 10 per 100,000 women-years, and >85% reduction in cervical cancer incidence rate. We conducted sensitivity analyses and presented the median age-standardised predictions of outcomes of the three models (minimum-maximum across models). Girls' vaccination could reduce age-standardised cervical cancer incidence from a median of 47.6 (40.9-79.2) in 2020 to 4.5 (3.2-6.3) per 100,000 women-years by 2120, averting on average ∼4% and ∼46% of age-standardised cumulative cervical cancer cases over 25 and 100 years, respectively, compared to the basecase. Adding 2 lifetime screens helped achieve elimination over the century among all women (2120 cervical cancer incidence: 3.6 (1.9-3.6) per 100,000 women-years), but not among WLHIV (10.8 (5.3-11.6)), and averted more cumulative cancer cases overall (∼45% over 25 years and ∼61% over 100 years compared to basecase) than girls' vaccination alone. Adding three-yearly cervical screening among WLHIV (to girls' vaccination and 2 lifetime cervical screens) further reduced age-standardised cervical cancer incidence to 3.3 (1.8-3.6) per 100,000 women-years overall and to 5.2 (3.9-8.5) among WLHIV by 2120 and averted on average 12-13% additional cumulative cancer cases among all women and 21-24% among WLHIV than girls' vaccination and 2 lifetime cervical screens over 25 years or longer. Long-term vaccine protection and using the nonavalent vaccine was required for elimination. High HPV vaccination coverage of girls and 2 lifetime cervical screens could eliminate cervical cancer among women overall in South Africa by the end of the century and substantially decrease cases among all women and WLHIV over the short and medium term. Cervical cancer elimination in WLHIV would likely require enhanced prevention strategies for WLHIV. Screening of WLHIV remains an important strategy to reduce incidence and alleviate disparities in cervical cancer burden between women with and without HIV, despite HIV interventions scale-up. World Health Organization. National Cancer Institute, National Institutes of Health. MRC Centre for Global Infectious Disease Analysis, UK Medical Research Council. National Institute of Child Health and Human Development research. Cancer Association of South Africa. Canadian Institutes of Health Research and the Fonds de recherche du Québec - Santé research.

Perception of Severity of Women at High Risk of Cervic Cancer About Cervic Cancer Screening Method IVA

Cervical cancer is the fourth most common cause of cancer in the world in women. The high mortality rate is due to the low awareness of women doing early detection. Behavior can be influenced by threat assessment, one of which is perceived severity. The behavior of early detection of cervical cancer can arise due to the perception of the severity of cervical cancer. Women's concern and desire for early detection of cervical cancer is influenced by women's perceptions of cancer. This study aims to explore the perception of the severity of women at high risk of cervical cancer regarding cervical cancer screening using the IVA method. This type of research is a qualitative research with a descriptive phenomenological approach. The research sample used purposive sampling technique. The study was conducted from April to May 2022 in the working area of ​​the Ujung Batu Health Center, 10 participants were interviewed for 25-35 minutes. The variable in this study is the perception of the severity of cervical cancer screening using the IVA method. The instrument used in this study is an interview guide and analyzed by thematic analysis. The results showed that all participants knew that the severity of cervical cancer can harm women and can cause death. The conclusion is that the awareness of participants in cervical cancer screening is still lacking. All participants understand the severity and seriousness of cervical cancer but have not screened for cervical cancer yet.

Barriers and recommendations for a cervical cancer screening program among women in low-resource settings in Lagos Nigeria: a qualitative study

BackgroundCervical cancer is the fourth most common cancer in women globally despite being a largely treatable and preventable malignancy. Developing countries account for over 80% of all new cases. Women residing in low-resource settings such as those residing in slums have a higher risk of cervical cancer, and lower uptake of cervical cancer screening. Diverse barriers influence the uptake of cervical cancer screening among women in low-resource settings.ObjectivesThis qualitative study was done prior to the introduction of a cervical cancer screening program in two slum areas in Lagos Nigeria and explored women’s knowledge about cervical cancer, and their perceived barriers and recommendations for the program.MethodFour focus group discussions(FGD) were conducted among 35 women between the ages of 21–65 years residing in two urban slums in Lagos, Nigeria from February to April 2019. Each FGD was limited to 8–10 participants of women of similar ages. Voice recordings were transcribed verbatim and thematic analysis was done.ResultsMost of the women were not aware of cervical cancer and none knew the symptoms or risk factors of cervical cancer. The participants felt that the cervical cancer screening program would be well accepted in the community, however, expressed concerns about the cost of the screening test and the sex of the person performing the test. The recommendations proffered for a successful cervical cancer screening program include; reducing the cost of the test or providing the test free of charge, having people that speak the local language as part of the team, using female health care providers, using a private location within the community or nearby primary health center, and publicizing the program with the use of SMS, phone calls, town crier, and health talks. It was recommended that organizing health education sessions would help improve women’s poorly perceived susceptibility to cervical cancer.ConclusionInterventions to increase uptake of cervical cancer screening among women in low resource settings need to improve knowledge of cervical cancer and address barriers to cervical cancer screening such as cost, distance, and as much as possible, sex of the healthcare provider should be considered.

Elucidation of Increased Cervical Cancer Risk Due to Polymorphisms in XRCC1 (R399Q and R194W), ERCC5 (D1104H), and NQO1 (P187S).

Genetic variations like single nucleotide polymorphisms (SNPs) are associated with cervical carcinogenesis. In this study, SNPs have been identified that contribute toward changes in the function and stability of the proteins and show association with cervical cancer. Initially, literature mining identified 114 protein-coding polymorphisms with population-based evidence in cervical cancer. Subsequently, the functional assessment was performed using sequence-dependent tools, and thereafter, protein stability was analyzed using sequence and structural data. Twenty-three non-synonymous SNPs (nsSNPs) found to be damaging and destabilizing were then analyzed to check their risk association at the population level. The meta-analysis indicated that polymorphisms in DNA damage repair genes XRCC1 (rs25487 and rs1799782), ERCC5 (rs17655), and oxidative stress-related gene NQO1 (rs1800566) are significantly associated with increased cervical cancer risk. The XRCC1 rs25487 and rs1799782 polymorphisms showed the highest risk of cervical cancer in the homozygous model having odds ratio (OR) = 1.85, 95% confidence interval (CI) = 1.17-2.92, p = 0.01, and recessive model with OR = 1.81, 95% CI = 1.01-3.24, and p = 0.04 respectively. Similarly, rs17655 polymorphism of ERCC5 and rs1800566 polymorphism of NQO1 showed the highest pooled OR in the homozygous (OR = 1.70, 95% CI = 1.32-2.19, p = 0.00004) and heterozygous model (OR = 1.3, 95% CI = 1.06-1.58, p = 0.01) respectively. Thus, in this study, a comprehensive collection of nsSNPs was collated and assessed, leading to the identification of polymorphisms in DNA damage repair and oxidative stress-related genes, that destabilize the protein and shows increased risk associated with cervical cancer.

Factors associated with cervical cancer screening among women living with HIV in the Kilimanjaro region, northern Tanzania: A cross-sectional study

Despite cervical cancer being a highly preventable disease, it is the fourth most common cancer among women in both incidence and mortality. Cervical cancer screening is crucial in preventing the disease. Women living with HIV (WLHIV) are at higher risk of cervical cancer because of their immune-compromised state. We aimed to determine factors associated with cervical cancer screening among WLHIV in the Kilimanjaro region, northern Tanzania.A cross-sectional study was conducted in the Kilimanjaro region among 297 WLHIV attending care and treatment centers (CTC) in northern Tanzania between August 21 and September 3, 2020; and interviewed using a questionnaire. Logistic regression model determined factors associated with cervical cancer screening at 5% significance level.Half (50.2 %) of the 297 WLHIV had ever screened for cervical cancer. WLHIV with positive attitudes towards cervical cancer screening (AOR = 3.48, 95 % CI 1.86, 6.51) and those who received information on cervical cancer from Health Care Providers (HCP) (AOR = 17.31, 95 % CI 6.00, 50.22) had higher odds of ever being screened for cervical cancer. Lower odds of screening (AOR = 0.50, 95 % CI 0.27, 0.96) were among women diagnosed with HIV within the past three years.WLHIV having a positive attitude towards screening and received cervical cancer screening information from HCP, were likely to have ever screened. Women newly diagnosed with HIV are less likely to have ever screened. HCPs at CTC are an important source of information about screening and for promoting cervical cancer screening among WLHIV. Special attention should be given to women newly diagnosed with HIV.