High Incidence Of Cervical Cancer Research Articles

Status of Healthy Choices, Attitudes and Health Education of Children and Young People in Romania—A Literature Review

Background and Objectives: This study aims to assess the health status and factors influencing healthy choices among children and young people in Romania, as well as the efficacy of related health education programs. Through understanding these dynamics, the study seeks to provide insights that can shape targeted interventions, policies, and educational strategies to improve this demographic’s overall health and well-being. Materials and Methods: For this study, we performed a literature review of original published papers on the health status, healthy habits, health education, predisposition to making healthy choices in the future, and accessibility to the paediatric health system of Romanian children and young people, as well as the effects of different types of educational interventions on this demographic in Romania. Results: The prevalence of dental caries is high in Romania. In terms of eating habits and nutritional status, a worrying proportion of children are overweight or obese, which can lead to a variety of future physical and psychological problems. In terms of physical activity, few adolescents demonstrate regular fitness practices. Romania presents an increase in alcohol and tobacco consumption among adolescents. The mental health of students has become a pressing public health concern, exacerbated by the COVID-19 pandemic. The use of social networks is linked to mental health issues among young people. Romania still has one of the highest rates of sexually transmitted diseases and faces a high incidence of cervical cancer, with a mortality rate three times higher than the EU average. High rates of teenage pregnancies are linked to limited information about sexuality and a lack of access to family planning at a young age. There are large discrepancies in the accessibility of medical services between urban and rural areas. Conclusions: Romania faces significant obstacles to providing high-quality healthcare to children and young people. Improving nutrition, immunisation rates, and access to medical services represent essential areas for enhancing the health of children and young people in Romania.

Prevalence of High-Risk Human Papillomavirus Infection, Associated Risk Factors, and Relationship With Cervical Precancerous Lesions in Perimenopausal and Older Women in an Area With High Cervical Cancer Incidence in China.

Purpose This study delves into the epidemiology of high-risk human papillomavirus (HR-HPV) infection and its link to precancerous lesions among perimenopausal (40-59 years) and elderly (60-65 years) women in a Chinese county with a notably high incidence of cervical cancer. By uniquely focusing on these age groups in underdeveloped regions, the research aims to offer novel strategies for the management and prevention of cervical cancer. It seeks to inform targeted interventions and public health policies that could significantly benefit women at heightened risk for HPV, addressing a critical gap in current prevention efforts in economically disadvantaged communities. Methods This observational study was conducted at the Maternal and Child Health and Family Planning Service Centre in Lueyang County, from September 2021 to January 2022. It assessed 2008 women aged 40-65 for HPV screening, with 342 undergoing further cytological examination. The study evaluated the prevalence of HPV infection across different age groups and risk categories. It utilized a questionnaire to collect participants' basic information, health behaviors, and other relevant data to analyze factors influencing HR-HPV infection. Statistical analyses comprised chi-square tests, trend analysis, logistic regression, and multiple imputation techniques to address missing data. Results The prevalence of HR-HPV infection among women aged 40-65 years in Lueyang County was 18.43%. Older women exhibited a higher incidence of HPV infection, abnormal ThinPrep Cytology Test (TCT) results (Shaanxi Fu'an Biotechnology Co.Ltd., Baoji City, China), and low/high-grade squamous intraepithelial lesions (LSIL/HSIL) (P<0.05). The most prevalent HR-HPV genotypes in the overall, perimenopausal, and elderly groups were HPV-52, -53, and -58; HPV-52, -53, and -16; and HPV-58, -52, and -53, respectively. The prevalent HR-HPV genotypes in the abnormal The Bethesda System (TBS) results were HPV-16, -52, -33, -58; -16, -52, -58; and-16, -33, and -52. HPV-16, -18, -33 prevalence increased with increasing lesion severity (P<0.05). In this study, factors affecting HR-HPV in the three age groups were found to be mainly related to sexual behavior and education level, including history of lower genital tract diseases, multiple pregnancies, contraceptive methods without tubal ligation, age at first marriage greater than 18 years, never washing the vulva after sex, abstinence from sex, education level of junior high school or above, and spouse's education level of high school or above. Conclusions These findings suggest that the elevated rate of abnormal TBS in the older age group may be attributed to the higher prevalence of persistent infection-prone HR-HPV genotypes (HPV-58, -52, and-53), multiple infections, and potent oncogenic HR-HPV genotypes (HPV-16 and -33). Additionally, the higher HR-HPV prevalence in older patients may be related to lower education attainment, reduced screening rate, and limited condom usage. Therefore, strategies targeting perimenopausal and older women should prioritize enhancing health awareness, increasing screening rates, and encouraging condom utilization.

The Saudi Population's Knowledge and Attitude Towards Human Papillomavirus (HPV) Infection and Its Vaccination.

Human papillomavirus (HPV) infection is a major worldwide public health concern that can result in a range of clinical disorders, including cervical cancer. Saudi Arabia, similar to numerous other nations, has difficulties in facing HPV and its impact on society. The high incidence of cervical cancer in Saudi Arabia continues to be a cause for worry, highlighting the need for the adoption of efficient immunization programs. Nevertheless, public hesitation and inadequate knowledge can hinder the acceptance of vaccines. Evaluating public knowledge and attitudes concerning HPV and its vaccination is essential in order to create focused programs that enhance awareness and increase vaccine acceptance. This study was cross-sectional in nature, using data from a sample of 516 Saudi participants 18 years and above. The participants completed online questionnaires that were distributed using Google Forms across social media platforms and ensured anonymity. A total of 516 participants made up the sample for this study, which had a predominance of females (83.5%, n=431); the majority aged 18-25 years (78.3%, n=404) and most of them (28.3%, n=146) were from the central region. The study results revealed that 43.7% (n=225) of the participants had a good knowledge level while 56.3% (n=291) of them had a poor level of knowledge about the HPV vaccine. A substantial proportion (35.9%, n=185) of the participants had good knowledge that HPV can be transmitted sexually from one person to another with only 30.2% (n=156) of them being aware that HPV is a common infection that causes cervical cancer (41.5%, n=214) and most of them (76.2%, n=393) knew that cervical cancer can be cured particularly when detected in early stages. The results established statistically significant associations between gender, education level, and occupation with p-values <0.005 (0.023, 0.003 and 0.001 respectively) and level of knowledge about the HPV vaccine. The study emphasizes the necessity of implementing focused health education and vaccination initiatives in Saudi Arabia to enhance understanding and attitudes regarding HPV infection and its vaccine. The results can provide guidance to healthcare professionals, legislators, and public health authorities in creating programs that increase knowledge and acceptance of the HPV vaccine, ultimately decreasing the prevalence of HPV-related diseases in the nation.

Abstract 2160: Utilizing geospatial analytics to identify neighborhood cancer hot spots for recruitment of underserved populations in clinical prevention research

Abstract Background: The term “precision public health” has increasingly been used in literature to describe public health practices that utilize new technologies and big data to precisely target the most vulnerable populations for disease control. Following the principles of precision public health, we used geospatial technologies and population-based health data to identify the locations and socioeconomic status of neighborhoods with high cancer incidences for recruitment of participants in prevention research. Methods: Using Florida cancer registry data, geospatial hot spot analyses were carried out to identify statistically significant clusters of census tracts with high incidences of prostate, gastric, and oral cancers within the catchment area of the Sylvester Comprehensive Cancer Center in South Florida. The locations, social determinants of health (US Census’ American Community Survey), and behavioral risk factor data (CDC’s Behavioral Risk Factor Surveillance System) of these hot spots were analyzed to identify the locations of underserved communities facing high risk for these three cancers. Results: Hot spots with high incidences for each of these three cancers overlap in many neighborhoods with high proportions of Hispanic and Non-Hispanic Black populations and high levels of socioeconomic disparities, such as low income, low education level, rental housing, no vehicles, and no access to health insurance. These neighborhoods also have high rates for behavioral risk factors in smoking, lack of physical activity, obesity, and high incidence of cervical cancer (high risk areas for HPV-associated oral cancers). Mobile screening units called the Game Changer Vehicles have been deployed to the locations to recruit participants who were tested on-site for prostate specific antigen (prostate cancer), H. pylori (gastric cancer), or solCD44 (a soluble tumor marker for squamous cell carcinoma) and total protein levels in oral rinse specimens, which can distinguish individuals with molecular features at risk for oral cancers due to tobacco, alcohol use, and human HPV infection. Conclusions: Geospatial analyses of population health data can be used to produce metrics that precisely target neighborhoods with high cancer risk and health disparities to recruit research participants. The same precision approach can also be applied for cancer screening purposes, such as offering cervical self-sample and fecal blood test kits in disadvantaged communities facing heightened risk for cervical and colorectal cancers. Citation Format: Ming S. Lee, Rebecca Kaiser, Ridhi Vyas, Amando Vera, Daniela Flores Quetant, Nancy Elliott, Valerie Bethel, Amanda Rivera, Shria Kumar, Brandon Mahal, Elizabeth Franzmann, Erin Kobetz. Utilizing geospatial analytics to identify neighborhood cancer hot spots for recruitment of underserved populations in clinical prevention research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2160.

Multiscale Optical Imaging Fusion for Cervical Precancer Diagnosis: Integrating Widefield Colposcopy and High-Resolution Endomicroscopy.

Early detection and treatment of cervical precancers can prevent disease progression. However, in low-resource communities with a high incidence of cervical cancer, high equipment costs and a shortage of specialists hinder preventative strategies. This manuscript presents a low-cost multiscale in vivo optical imaging system coupled with a computer-aided diagnostic system that could enable accurate, real-time diagnosis of high-grade cervical precancers. The system combines portable colposcopy and high-resolution endomicroscopy (HRME) to acquire spatially registered widefield and microscopy videos. A multiscale imaging fusion network (MSFN) was developed to identify cervical intraepithelial neoplasia grade 2 or more severe (CIN 2+). The MSFN automatically identifies and segments the ectocervix and lesions from colposcopy images, extracts nuclear morphology features from HRME videos, and integrates the colposcopy and HRME information. With a threshold value set to achieve sensitivity equal to clinical impression (0.98 [p = 1.0]), the MSFN achieved a significantly higher specificity than clinical impression (0.75 vs. 0.43, p = 0.000006). Our findings show that multiscale optical imaging of the cervix allows the highly sensitive and specific detection of high-grade precancers. The multiscale imaging system and MSFN could facilitate the accurate, real-time diagnosis of cervical precancers in low-resource settings.

Prevalence of cervical intraepithelial lesions and associated factors among women attending a cervical cancer clinic in Western Uganda; results based on Pap smear cytology.

There are high incidence and mortality rates of cervical cancer among females in East Africa. This is exacerbated by limited up-to-date data on premalignant lesions and associated factors in this setting. In this study, we determined the prevalence of cervical intraepithelial lesions and associated factors among women attending the Mbarara Regional Referral Hospital cervical cancer clinic in Southwestern Uganda. In this cross-sectional study, 364 participants were recruited from among women attending the Mbarara Regional Referral Hospital cervical cancer clinic from 1 April to 30 June 2023. On consent, the study nurse collected demographic data and Pap smears, which were microscopically examined and reported by a laboratory scientist and a pathologist following the Bethesda grading system (2014). Statistical analyses were done in STATA version 17, using proportions, Chi-square, bivariate, and multivariate logistic regression analysis to determine associated factors at ⩽0.05 significance level. The mean age of participants was 41.9 years. A third of all study participants (37.6%, 132/351) were contraceptive users, mostly hormonal contraceptives (87.1%, 115/132). Almost 88% (307/351) had an unknown Human Papilloma Virus status. The prevalence of cervical intraepithelial lesions among our study participants was 6.6% (23/351), of which 73.9% (17/23) were low-grade squamous intraepithelial lesions. More than half (9/17, 52.9%) of low-grade squamous intraepithelial lesions were active hormonal contraceptive users. Use of hormonal contraceptives (OR: 3.032, p: 0.0253), use of intrauterine devices (OR: 6.284, p: 0.039), and any family history of cervical cancer (OR: 4.144, p: 0.049) were significantly associated with cervical intraepithelial lesions. The prevalence of cervical intraepithelial lesions was 6.6%, lower than global estimates. Use of hormonal and intrauterine device contraceptives, as well as family history of cervical cancer, were significantly associated with cervical intraepithelial lesions among our study population. Prospective studies are recommended to further understand associations between different types of intrauterine devices and hormonal contraceptives, and cervical lesions.

Comprehensive Information Learning Training for Productive Age Mothers in the Cervical Cancer Prevention and Care Movement (GERCEP) in the Community

Cervical cancer is the leading cause of cancer death for women in developing countries. The incidence of cervical cancer will increase four times greater in family planning acceptors who use hormonal contraceptives with a duration of more than five years. The high incidence of cervical cancer requires counseling for the community to conduct early detection of the possibility of cervical cancer. Through training and mentoring activities with comprehensive learning in productive age mother groups in the cervical cancer prevention and care Movement (GERCEP) efforts in the community that can increase knowledge as well as early prevention of cervical cancer and health maintenance efforts for productive age mothers. The method of implementing community service activities is carried out by providing education, learning training in the form of quizzing to 50 productive age mother groups. Education is carried out by providing health counseling about cervical cancer and how to prevent it through PHBS. The results of the implementation of this community service activity show that the mother's knowledge about cervical cancer and its prevention is in the good category (100%), after learning training activities. The results of the paired t-test test before and after being given learning training obtained a p value of 0.000. The results of this activity are expected that mothers are able to increase knowledge and insight in efforts to prevent cervical cancer through clean and healthy living behaviors.

Abstract C101: Development of an educational text messaging program to improve human papillomavirus awareness, knowledge, and vaccination intention among Korean young adults in the U.S.

Abstract Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the U.S. Cervical cancer (CC) is the most common HPV-associated cancer, and Korean Americans (KAs) experience one of the highest CC incidence and mortality rates among Asian Americans. Awareness and knowledge of HPV and HPV vaccine are essential in preventing HPV-associated cancers; however, studies emphasize low HPV awareness and knowledge among KAs. Although HPV causes cancers in both men and women, there exist misconceptions that the HPV vaccine is only for women and not for men. Furthermore, research on HPV vaccination among KAs has been conducted mostly among women. The health belief model (HBM) is a value-expectancy theory that is used to explain and predict individual changes in health behaviors and has been used in multiple studies that aimed to understand HPV vaccination behavior. Purpose: The purpose of this study is to develop an HBM guided text messaging program to increase HPV awareness, knowledge, and HPV vaccination among Korean young adults in the U.S. Methods: A total of 10 Korean young adults between the ages of 18 and 26 completed the mixed methods study. The survey examined HPV, HPV vaccine, and cervical cancer awareness and knowledge, beliefs, and vaccination intention. The qualitative interview with cognitive response testing (CRT) of the text messages, which were preconstructed based on previous literature and six constructs of HBM, allowed participants to provide feedback on the comprehension and emotional response to the messages, and any other recommendations to improve the content and delivery of the messages. Results: All participants (N=10) indicated to have never received the HPV vaccine and most participants had no intention to receive the HPV vaccine within one year. Although most of the participants were aware of HPV and HPV vaccine, overall knowledge of HPV, HPV vaccine, and cervical cancer were low. The interviews revealed that reasons for vaccine hesitancy and non-vaccination included cost, inconvenience, and low perceived susceptibility. Especially, there was low perception of the importance of HPV vaccination for males. Overall, findings from the CRT showed that there was a clear understanding of the preconstructed text messages. There was a consensus on the duration and timing of the messages and participants provided recommendations on the content, tone, and structure of the messages. Using the HBM, participants’ feedback on HPV awareness, knowledge, and vaccination intention, the text messaging library was revised and includes a total of 9 text messages over the four days. Conclusions: This study provides important insights into the development of an educational text messaging program among Korean young adults in the U.S. Current study will build a foundation for an educational mobile health program to help increase awareness and knowledge of HPV and HPV-associated cancers, as well as HPV vaccination intention, and impact HPV-associated cancer rates among KAs through vaccination in the long term. Citation Format: Min Jeong Jeon, Daisy Le. Development of an educational text messaging program to improve human papillomavirus awareness, knowledge, and vaccination intention among Korean young adults in the U.S. [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C101.

Adapting a model of cervical carcinogenesis to self-identified Black women to evaluate racial disparities in the United States.

Self-identified Black women in the United States have higher cervical cancer incidence and mortality than the general population, but these differences have not been clearly attributed across described cancer care inequities. A previously established microsimulation model of cervical cancer was adapted to reflect demographic, screening, and survival data for Black US women and compared with a model reflecting data for all US women. Each model input with stratified data (all-cause mortality, hysterectomy rates, screening frequency, screening modality, follow-up, and cancer survival) was sequentially replaced with Black-race specific data to arrive at a fully specified model reflecting Black women. At each step, we estimated the relative contribution of inputs to observed disparities. Estimated (hysterectomy-adjusted) cervical cancer incidence was 8.6 per 100 000 in the all-race model vs 10.8 per 100 000 in the Black-race model (relative risk [RR] = 1.24, range = 1.23-1.27). Estimated all-race cervical cancer mortality was 2.9 per 100 000 vs 5.5 per 100 000 in the Black-race model (RR = 1.92, range = 1.85-2.00). We found the largest contributors of incidence disparities were follow-up from positive screening results (47.3% of the total disparity) and screening frequency (32.7%). For mortality disparities, the largest contributor was cancer survival differences (70.1%) followed by screening follow-up (12.7%). To reduce disparities in cervical cancer incidence and mortality, it is important to understand and address differences in care access and quality across the continuum of care. Focusing on the practices and policies that drive differences in treatment and follow-up from cervical abnormalities may have the highest impact.

Decision-Making Regarding Elective Child and Adolescent Vaccinations Among Native Hawaiian and Pacific Islander Parents in Orange County.

Native Hawaiians and Pacific Islanders (NHPIs) in aggregate experience greater health burdens than non-Hispanic Whites, such as a higher incidence of cervical cancer and COVID-19. Given the importance of vaccinations in preventing and reducing the severity of diseases, such as the flu, cervical cancer, and COVID-19, the receipt of vaccines during childhood and adolescence is crucial. Therefore, this qualitative study aimed to explore the factors associated with NHPI parents' decisions regarding vaccinating their children with these elective vaccinations-that is, vaccinations not required for child care, preschool, or K-12 admissions in California but highly recommended. A total of 15 NHPI parents were recruited through a community-based organization. Semi-structured interviews explored parents' reasons for accepting or denying each vaccine for their child(ren). Results demonstrated variable acceptance of each vaccine, though consistent themes included protection and concerns over side effects. This study also found two general types of parents-those who treat vaccines the same and those with varying opinions about each vaccine. Results from this study demonstrate the family- and community-oriented nature of NHPI communities, suggesting that future interventions target not only parents but also their families and communities to cultivate vaccine acceptance through social networks. Furthermore, addressing all three vaccines during well-child visits may benefit parents who view each vaccine as separate entities with individual pros and cons. Such interventions could contribute toward reducing the burdens of particularly chronic health disparities.

Implementation of Nursing Care for Clients with Stadium IIA Cervic Cancer in Anxiety Disorders with Benson's Relaxation in The Pavilion of Faith Sudjudi Floor II Gatot Soebroto Army

Cervical cancer is a malignant process that occurs in the cervix, so that the surrounding tissue cannot carry out its functions as it should. The high incidence of cervical cancer in Indonesia has made cervical cancer a major health problem and one of the highest causes of death. It is noted that the incidence of cervical cancer in Indonesia is 36,000 cases or 9.2% of the total cancer cases and ranks second after breast cancer. Cervical cancer is a disease that causes psychological disturbances in the form of anxiety. One therapy that can reduce anxiety is benson relaxation. The purpose of this writing study is to describe nursing care for cervical cancer patients in anxiety disorders with Benson relaxation. The method used is descriptive research in the form of a case study. The characteristics of the subjects of this study were patients who experienced postoperative anxiety about cervical cancer with the HARS scale rating, with a score of 39 with a severe level of anxiety decreasing to 19 with mild anxiety. The results of this study found that in cervical cancer patients. after applying the Benson Relaxation technique can reduce the anxiety experienced by patients. The conclusion from this case study is that Benson's Relaxation Therapy is effective for reducing anxiety, from a score of 39 with a severe level of anxiety there is a decrease to 19 with mild anxiety.

Challenges in the Sustainability of Brachytherapy Service in Contemporary Radiotherapy

Brachytherapy has a long history of delivering a highly conformal radiation dose to the target volume with sparing of adjacent normal tissue and has an irreplaceable role in certain cancers, such as cervical and prostate cancers. There have been futile attempts to replace brachytherapy with other radiation techniques. Despite that there are multifaceted challenges in preserving this dying art, from establishment, to a trained workforce, to maintenance of the equipment and source replacement costs. Here we focus on the challenges to access brachytherapy, the availability and distribution of care across the globe and appropriate training leading to proper implementation of the procedure. Brachytherapy holds a significant place in the treatment armamentarium of most common cancers, such as cervical, prostate, head and neck and skin cancers. However, there is an uneven distribution of brachytherapy facilities, not only across the globe, but also at a national level, with a larger proportion of facilities concentrated in certain regions, more so in low and low-middle income countries. The regions with the highest incidence of cervical cancer have the least access to brachytherapy facilities. Attempts to bridge the gap are essential and should be focused on uniform distribution and access to care, improving training of the workforce through specialised training programmes, reducing the cost of care, planning to reduce the recurring cost, generating evidence and research guidelines, renewing interest in brachytherapy through rebranding, use of social media and building an attainable long-term roadmap.

Barriers and facilitators to effective cervical cancer screening in Belize: a qualitative analysis

PurposeBelize has among the highest cervical cancer incidence and mortality rates of Latin American and Caribbean countries. This study evaluates the perspectives of key stakeholders for cervical cancer screening in Belize and identifies the barriers and facilitators for providing equitable access to prevention services.MethodsSemi-structured interviews discussing cervical cancer screening were conducted with key stakeholders across the six districts of Belize in 2018. Interviews were transcribed, coded, and analyzed thematically; themes were organized by levels of the social-ecological model.ResultsWe conducted 47 interviews with health care providers (45%), administrators (17%), government officials (25%), and other stakeholders (13%). Majority (78%) of interviews were from the public sector. Perceived barriers to cervical cancer screening were identified across multiple levels: (1) Individual Patient: potential delays in Pap smear results and fear of a cancer diagnosis; (2) Provider: competing clinician responsibilities; (3) Organizational: insufficient space and training; (4) Community: reduced accessibility in rural areas; and (5) Policy: equipment and staffing budget limitations. The main facilitators we identified included the following: (1) at the Community level: resource-sharing between public and private sectors and dedicated rural outreach personnel; (2) at the Policy level: free public screening services and the establishment of population-based screening.ConclusionDespite free, publicly available cervical cancer screening in Belize, complex barriers affect access and completion of management when abnormal screening tests are identified. Provider workload, education outreach, and additional funding for training and facilities are potential areas for strengthening this program and increasing detection and management for cervical cancer control.

Cervical Cancer in Case with Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI)

Background: Combined cervical cancer and pelvic organ prolapse (POP) is extremely uncommon and there is no standard treatment guideline for the complex comorbidity. We attempted to provide a treatment strategy and explore possible reasons for the comorbidities. Case presentation: We presented a 62-year-old patient seeking treatment for postmenopausal tissue prolapse and leakage of urine. The gynecologic examination revealed the uterine prolapse with a 2.5 cm papillary and erosive lesion on the cervix that was pathologically confirmed as cervical squamous cell carcinoma in stage Ib1. Clinical diagnosis included cervical squamous cell carcinoma in stage Ib1, prolapse of uterus and vagina, stress urinary incontinence (SUI). Then she was performed radical surgery for cervical cancer and tension-free vaginal tape-obturator (TVT-O). The urine function was good after operation. The surgery solved two diseases, which improved the quality of life (QOL) of patient and radically cured cervical carcinoma at the same time. Follow up for more than two years, HPV was negative, no prolapse symptoms occurred, and the quality of life was good. Conclusions: Surgical-based treatment seems to be more suitable that can cure the two diseases and improve the QOL. We should pay attention to the potential high incidence of HPV infection and HPV-related cervical cancer so that we should not ignore the screening for cervical cancer in the prolapse group and initiate surgery treatment strategies of cervical cancer or pre-cancerous lesions as early as possible to reach an optimal outcome of patient.

Anti-tumour and radiosensitising effects of PARP inhibitor on cervical cancer xenografts

This study evaluated the radiosensitising effect of niraparib; a poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitor on HeLa cervical cancer cells in nude mice and explored its possible mechanism. Twenty-four 3–5-week-old female BALB/c nude mice, inoculated with HeLa cells into the right hind leg, were randomly assigned into eight groups with three mice per group and treated. The tumour volume was significantly reduced under niraparib + radiotherapy combination as compared to monotherapy and untreated mice. The tumour growth was significantly delayed by 23.33–39 days when treated with combination therapy (p<.05). Further, univariate analysis revealed prolonged time for tumour growth when radiotherapy was followed by niraparib (I.G.) rather than niraparib (I.P.) (p=.003). Combination therapy reduced levels of PARP-1 precursor, PARP-1 splicer, PAR and RAD51 protein with high expression of γ-H2AX/CC3 and low expression of Ki-67. Niraparib in combination with radiotherapy can enhance the formation of DNA double strand breaks in HeLa cells and up regulate the expression of γ-H2AX/CC3. IMPACT STATEMENT What is already known on this subject? Asia has the highest incidence of cervical cancer (58.2%). Poly(adenosine diphosphate-ribose) polymerases (PARPs) are family of enzymes involved in single-strand break (SSB) and double-strand break (DSB) repair pathways. Niraparib is an effective inhibitor of both PARP-1 and PARP-2 and has the ability to cross the blood–brain barrier. What the results of this study add? Our study demonstrated that the combination of niraparib and radiotherapy can significantly enhance the cytotoxicity induced by radiotherapy. The inhibition effect of radiotherapy combined with niraparib on the tumour growth of mice was prominent, thereby establishing the radio-sensitisation activity of niraparib. What are the implications of these findings for clinical practice and/or further research? Niraparib can improve the cytotoxic effect of radiotherapy by increasing the formation of DSBs and up regulating the expression of apoptotic protein in HeLa cells.

P833 Cervical cancer risk in newly diagnosed ulcerative colitis: a nationwide population-based study

Abstract Background The association between ulcerative colitis (UC) and increased risk of cervical cancer in women remains controversial. We investigated cervical cancer risk in South Korean UC patients using the Korean National Health Insurance (NHI) claims data. Methods UC definitions included both ICD-10 codes and UC-specific prescriptions. We analyzed incident cases diagnosed between 2006 and 2015. Age-matched women without UC (control group) were randomly selected from the general population (1:3 ratio). Hazard ratios (HRs), adjusted for different covariates, were calculated using multivariate Cox proportional hazard regression. In total, 12,632 and 36,797 women with and without UC, respectively, were enrolled. Results Cervical cancer developed in 0.21% (68 person-years) and 0.14% (172 person-years) of UC patients and controls, respectively. The HR (95% CI) of cervical cancer in the UC group, with reference to the control group, was 1.56 (0.97-2.50). HR, stratified by age, was significantly high in elderly UC patients (≥60 years) at 3.65 (1.54–8.66). In UC patients, old age (≥40 years) and low socioeconomic status were associated with increased cervical cancer risk. Conclusion Elderly UC patients had a higher incidence of cervical cancer than age-matched controls in Korea, suggesting that elderly patients with newly diagnosed UC should be screened for cervical cancer.

Abstract A118: Uptake of cervical cancer screening services in urban Zimbabwe: Healthcare provider perspectives

Abstract Background: In sub-Saharan Africa, Zimbabwe is among the top 6 countries with the highest cervical cancer incidence and mortality rates. Despite the disproportionate and growing burden, uptake of cervical cancer screening remains low. Little is known about the perceptions of healthcare providers who play a vital role in the provision and implementation of cervical cancer screening. This study explores healthcare provider perceptions of the factors that influence the uptake of cervical cancer screening in Zimbabwe. Methods: One-on-one in-depth interviews were conducted with healthcare providers currently or previously involved in cervical cancer prevention programs at select hospitals and clinics in Harare and Chinhoyi – two urban cities in Zimbabwe. A deductive thematic approach was used to analyze qualitative data to understand factors influencing the provision and uptake of cervical cancer screening. Results: We conducted 21 interviews with healthcare providers working in cervical cancer prevention for an average of 4 years. Three main themes related to the provision of cervical cancer screening were funding availability through donor support, demand of screening services, and availability of technical and human resources. Experiencing symptoms and no-cost screening services were perceived as facilitators for uptake of cervical cancer screening, while lack of adequate health education about cervical cancer and misconceptions about the screening procedure and outcomes were perceived as barriers to uptake of screening. Majority of the providers recommended increased sensitization and health education through various platforms; outreach initiatives; and training of more healthcare providers to conduct cervical cancer screening. Conclusion: This study contributes to a holistic understanding and identification of intervention points to effectively increase uptake of cervical cancer screening. Multi-level strategies promoting awareness of cervical cancer screening and strengthening healthcare systems may contribute significantly to increasing cervical cancer screening rates which in turn will lead to reducing the burden of cervical cancer in Zimbabwe. Citation Format: Thembekile Shato, Ucheoma Nwaozuru, Eric Adjei Boakye, Qiang John Fu, Juliet Iwelunmor, Anne Sebert Kuhlmann. Uptake of cervical cancer screening services in urban Zimbabwe: Healthcare provider perspectives [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A118.

Early Detection Program for Breast and Cervical Cancer in Indonesia: How is Implementation?

Breast and cervical cancer have ranked first and second in terms of the highest cancer cases in Indonesia. The high incidence of breast and cervical cancer is due to the low coverage of early detection. This study aimed to examine the implementation of breast cancer early detection programs using the SADANIS method and cervical cancer using the IVA method. This current study used a qualitative and descriptive approach through input, process, output, and impact variables. Data was collected through in-depth interviews, observation, and documentation review. The results revealed that the number of trained human resources, facilities, and infrastructure was sufficient. The program had also implemented online and offline information systems and was actively conducting inspections integrated with the “Family Planning” program. The high achievement of the program had also been supported by the existence of an innovative screening system and direct examination in the community. The program achievements for 2021-2022 (January-June) and cases of cervical cancer had decreased. Implementing the early detection program for breast and cervical cancer is considered better. It can thus become a model for other regencies.&#x0D;

Perspectives of Cervical Cancer Screening Among First-Generation Nigerian Immigrants Living in Diaspora

Despite the drop in cases of cervical cancer across the western world, there is still an ethnic inequality with lower cervical screening rates and higher incidence of cervical cancer reported among ethnic minorities and immigrants from developing nations. This study aims to explore reasons for this, through the perspectives of female, first-generation Nigerian immigrants regarding cervical cancer screening. The study utilises a cross-sectional design. It takes a qualitative approach using one-on-one in-depth interviews of female participants who are Nigerian-born immigrants currently living in Leeds, United Kingdom. By relying on thematic analysis, the study found that the country of origin of immigrants plays a significant role in shaping perspective towards cervical screening; hence, the health-seeking behaviours of immigrants. It is therefore imperative that a global health approach that also addresses cervical cancer screening challenges including lay perspectives in developing nations be adopted.

Risks and treatment for recurrent intraepithelial cervical lesions

Background. Persistently high incidence of cervical cancer in Russia and significant number of cases detected in the late stages necessitate the improvement of secondary prophylaxis of this disorder.Aim. To assess risk factors for recurrent high-grade cervical intraepithelial neoplasia (CIN2+) (high grade squamous intraepithelial lesions, HSIL) after cervical conization.Materials and methods. This study included 62 patients with recurrent HSIL treated in Novosibirsk Regional Clinical Oncology Dispensary, E. N. Meshalkin National Medical Research Center, “Zdorovye” LLC, “Avismed” LLC, Tomsk National Research Medical Center of the Russian Academy of Sciences, and Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation in 2017–2021. We analyzed patients’ human papillomavirus (HPV) status, performed repeated examination of excised tissue specimens to evaluate the severity of lesions and resection margins, as well as immunohistochemical examinations. We found that mean time to cytologically confirmed recurrent HSIL was 16.0 ± 5.6 months. All patients were HPV-positive. Repeated histological examination demonstrated that 18 samples had positive resection margins or endocervical crypt involv ement. Fifty-seven samples had positive staining for p16 at immunohistochemical examination; 46 samples had Ki-67 &gt;30 %, which indicated high risk of recurrence. Treatment of patients with recurrent HSIL included repeated excision up to healthy cervical tissues, followed by intravaginal therapy with Cervicon-DIM 100 mg twice a day (for 3 months). Follow-up examinations after 18.0 ± 6.2 months on average showed no HPV persistence and no HSIL recurrence.Conclusion. Endocervical crypt involvement along the primary resection margin, underestimated severity and depth of lesions (at the first surgery), and persistence of HPV infection are the main risk factors for recurrent cervical dysplasia or carcinoma in situ. Combination treatment that includes additional excision with a subsequent course of Cervicon-DIM is sufficient and effective.