Incidence Of Cervical Carcinoma Research Articles

Molecular and Potential Biomarkers in Diagnosis of Cervical Carcinoma: A Review

Cervical cancer, a potentially preventable disease remains the second most common malignancy in women worldwide. Persistent infection with oncogenic human papillomavirus (HPV) is the main risk factor for cervical cancer and its precursor lesions. It starts in the cell lining of the cervix which includes abnormal cell division and functions. Cytological screening programs using the Pap test have led to a substantial reduction in the incidence of cervical carcinoma. The identification of new biomarkers that allows monitoring of molecular events associated to tumour progression in histological or cytological specimens may improve the detection of lesions with higher risk of progression. In the present article we review on molecular and potential biomarkers that interfere in the pathophysiology of disease and their possible role in screening and diagnosis of cervical cancer.

Incidence of pre-neoplastic and neoplastic lesions of the cervix before and after the COVID-19 pandemic

ObjectiveThe COVID-19 pandemic had significant effects on healthcare systems worldwide, including the disruption of routine screening programs for cervical cancer. This study aimed to compare the incidence of cervical intra-epithelial...

The diagnostic value of lncRNA HOTAIR for cervical carcinoma in vaginal discharge and serum.

There is a lower incidence of cervical carcinoma compared with other common carcinomas, however, the mortality rate of cervical carcinoma is higher, suggesting that the treatment and prognosis of cervical carcinoma are relatively poor. Therefore, cervical carcinoma patients urgently need to find new diagnostic markers for early detection and treatment. One hundred and fifty cervical carcinoma and 100 benign cervical disease patients from 2019 January to 2021 December in Tianjin Central Hospital of Gynecology Obstetrics were selected and 100 healthy women were as normal group. The expression of HOX transcript antisense RNA (HOTAIR) in cervical carcinoma and paracancerous tissue, serum sample was measured by realtime PCR assay. The receiver operating characteristic of HOTAIR for cervical carcinoma was analyzed. The study found that the expression level of HOTAIR in primary cervical carcinoma is closely related to tumor metastasis and prognosis. The expression level of HOTAIR in paracancerous tissue was significantly lower than that in cancer tissue, and the expression level of HOTAIR in vaginal discharge and serum was higher than that in cervical carcinoma patients which was positively correlated with tumor malignancy, meanwhile, HOTAIR was significantly reduced after surgery 3 months both in vaginal discharge and serum. In order to examine the diagnostic efficiency of HOTAIR for cervical carcinoma, we found that the area under curve of vaginal discharge was 0.9723, sensitivity was 92%, specificity was 98%, the area under curve of serum was 0.8518, sensitivity was 79%, and specificity was 94% by receiver operating characteristic analysis. The accuracy were 92.7% and 89.3% in vaginal discharge and serum via certified by cervical carcinoma and benign cervical disease patient and healthy people. The above results show that the diagnostic performance of HOTAIR in vaginal discharge is higher than that of serum, and it is expected to become a marker for cervical carcinoma diagnosis and treatment.

Human papillomavirus-associated cancer incidence by disaggregated Asian American, Native Hawaiian, and other Pacific Islander ethnicity.

Asian Americans and Native Hawaiians and other Pacific Islanders have suboptimal human papillomavirus (HPV) vaccination and cancer screening rates. Asian Americans and NHPIs are often aggregated, masking disparities characterized by varying colonization and immigration patterns and cultural and religious beliefs between populations and ethnicities. We examined the incidence of HPV-associated cancers across disaggregated Asian American and NHPI ethnicities. Using the Surveillance, Epidemiology, and End Results Detailed Asian/Pacific Islander database, we calculated 1990 to 2014 sex-specific, age-standardized HPV-associated cancer incidence of cervical carcinoma, oropharyngeal squamous cell carcinoma (SCC), vulvar SCC, vaginal SCC, anal SCC, and penile SCC by ethnicity: Asian Indian and Pakistani, Chinese, Filipino, Japanese, Kampuchean, Korean, Laotian, Native Hawaiian, other Pacific Islander, and Vietnamese. Trends by calendar period (1990 to 1996, 1997 to 2002, 2003 to 2008, 2009 to 2014) were estimated using Joinpoint regression. The most common HPV-associated cancer was cervical carcinoma in women and oropharyngeal SCC in men. During 1990 to 2014, cervical carcinoma incidence per 100 000 ranged from 4.5 (Asian Indian and Pakistani) to 20.7 (Laotian). Cervical carcinoma incidence only statistically significantly declined for Asian Indian and Pakistani, Filipino, Korean, Laotian, and Vietnamese women (range = 19.9% to 44.1% decline per period). Among men, oropharyngeal SCC incidence per 100 000 ranged from 1.1 (Chinese) to 5.1 (Native Hawaiian). Oropharyngeal SCC incidence only statistically significantly increased (31.0% increase per period) for Japanese men. Heterogeneity across ethnicities were observed for other cancer sites. HPV-associated cancer incidence varied widely between Asian Americans and NHPIs and by ethnicity, underscoring the need for improved data capture of ethnic groups in research and more tailored interventions to better address health disparities between Asian American and NHPI populations.

High sensitivity and specificity rates of cobas® HPV test as a primary screening test for cervical intraepithelial lesions in a real-world setting.

Cervical carcinoma (CC) is the fourth most common malignancy among women. Screening with Papanicolau smear is linked to a reduction in CC incidence rates when screening programs have been developed. However, this technique has several limitations, including moderate sensitivity rates for detection of cervical preneoplastic HPV-related lesions. In this real-world study, we proposed to evaluate the sensitivity and specificity rates of cobas® test, which amplifies target DNA fragments by polymerase chain reaction and hybridization of nucleic acids for the detection of 14 HR-HPV types in a single analysis) used as primary screening test for CC and preneoplastic lesions in women aged 25-65 years in a large University Hospital in Buenos Aires. A total of 1044 patients were included in the sample (median age: 46 years); sensitivity and specificity rates for the HR-HPV test used as primary screening test were 98.66% (95% confidence interval [95CI]: 97.67-99.3%) and 87.15% (95CI: 84.93-89.15%), respectively. The positive predictive value was 88.47% (95CI: 86.54%-90.42%) and the negative predictive value was 98.48% (95CI: 97.75%-99.23%). The cobas® HR-HPV testing was highly sensitive and specific for the detection of CC and preneoplastic lesions in real practice.

Preventive health care in India: Are we doing enough

Preventive health care in India: Are we doing enough

Awareness of Human Papillomavirus Vaccine among Females in Riyadh in 2021

Background: Human papillomavirus (HPV) is a DNA virus which mainly spreads through sexual contact and is the most causative agent of cervical cancer, the fourth most common cancer among women worldwide, and the eighth most frequent cancer among women in Saudi Arabia. The currently available HPV vaccines can markedly decrease the incidence of this cancer. Methods: This cross-sectional study was conducted to estimate the awareness level about HPV, its transmission methods, its link to cervical carcinoma, and its vaccine protection against cervical cancer among females in Riyadh in 2021. This study was conducted through an electronic questionnaire and included 1,003 females aged ≥18 years old of different education levels and marital statuses. Results: The results show that the awareness about HPV is significantly low, only 30% of participants were aware of HPV, and only half of those had information about the HPV vaccine. In addition, only 20% of the participants knew that HPV is transmitted sexually. The level of knowledge was low even among health care workers, only 58% of them were aware of HPV, and 53% of them lack knowledge about the vaccine. Conclusion: According to our data, females in Riyadh have a significantly low awareness of HPV and its vaccination. Based on our outcome, we recommend increasing awareness about HPV infection and the importance of vaccination in decreasing the incidence of cervical carcinoma.

Advanced stage cervical cancer: Who is at risk and is it related to screening and vaccination practices? (441)

<b>Objectives:</b> Advanced-stage cervical cancer is challenging to treat and is usually a terminal diagnosis focusing on palliation, not cure. We aimed to examine the trends in advanced-stage cervical cancer and explore the groups where this diagnosis is increasing. We also looked at changes in cervical cancer screening and vaccination patterns to understand if there is a correlation between these trends. <b>Methods:</b> Data on cervical carcinoma incidence and rates were obtained from the U.S. Cancer Statistics program from 2001 to 2018. Rates of cervical cancer screening and HPV vaccination were evaluated using the Behavioral Risk Factor Surveillance System and TeenVaxView (BRFSS: 2001-2016, TeenVaxView: 2008-2016, 13-17 years olds). SEER*Stat 8.3.8 and Joinpoint regression program 4.8.0.1 were used to calculate incidence trends. Since all the data used in this study were derived from de-identified files, no institutional review board approval was required for this study. <b>Results:</b> The incidence of advanced cervical cancer was 0.94/100,000 in 2018. Non-Hispanic Black (NHB) women had the highest incidence of cervical cancer at 1.33/100,000. Between the years 2001 and 2018, advanced-stage cervical cancer had been on the rise in all women with an average annual percent change (AAPC) of 1.24% (p<0.001). When examining race, rates were stable in all groups except Non-Hispanic White (NHW) women, where there was an increase of 1.67% per year (p<0.001). The South had the largest increase of all regions in the US with an AAPC of 2.11% (p<0.001). NHW women in the South had the largest increase with an AAPC of 2.79% (p<0.001). Dividing age into five years age groups, 85% of the increasing rate were found in patients younger than 60 years. More specifically, those within the age range of 30-34 years had a 3.27% increase per year. When examining age, rates were increasing in most younger age groups less than 60 years, with the largest increase in the 30-34 years old age group at 3.27% (p<0.001). When performing an intersection analysis, NHW in the South aged 40-44 had the highest rise in advanced cervical cancer at a rate of 4.56% annually (p<0.001). Using the BRFSS data, we found that NHW women had the highest rates of non-guideline screening (last pap smear > 5 years ago) at 26.65%, almost double compared to NHB women at 13.79%. The suboptimal screening had been increasing in all racial groups at 6.1% annually (p<0.001). When looking at vaccination, NHB women had the highest vaccination rate at 17.07%; however, vaccination rates were rising most quickly in NHW at an AAPC of 24.8% (p<0.001). When looking specifically at the teenage population, NHW girls aged 13-17 had the lowest vaccination rate at 66.10% compared to Hispanic girls at 75.30%. Rates of vaccination were rising the most in NHB girls at 6.9% annually (p<0.001). <b>Conclusions:</b> Disparities exist among diagnoses of advanced-stage cervical cancer, with rates disproportionately affecting minorities. However, advanced-stage cervical cancer is on the rise in the United States, especially in younger NHW women. Upon examining the screening and vaccination practices, NHW were more likely to be non- compliant with pap smear screening, and young NHW girls, for whom the vaccine was recommended, had the lowest vaccination rates. These factors could contribute to a rise in more advanced stage diagnosis.

LncRNA ABHD11-AS1 Participates in the Progression of Cervical Carcinoma by Targeting miR-1254 and Is the Key to the Diagnosis and Treatment of Cervical Carcinoma in the Future.

Cervical carcinoma is the most common gynecologic tumor in the clinic. The incidence of cervical carcinoma has been increasing in recent years, and the age of the affected population is showing a younger trend. Long-chain noncoding RNA (LncRNA) acts in the cell cycle. In cervical carcinoma, many studies have also confirmed the important role of LncRNA. LncRNA ABHD11-AS1 is one of the genes abnormally expressed in cervical carcinoma, but the specific situation has not been fully explained. This study intended to confirm whether LncRNA ABHD11-AS1 can be applied for the treatment of cervical carcinoma in the future. From January 2015 to January 2017, 72 cases of cervical carcinoma patients and 78 cases of healthy people during the same period in our hospital were selected for prospective analysis. ABHD11-AS1 and miR-1254 in serum and carcinoma tissues of cervical carcinoma patients were detected. In addition, human cervical carcinoma cells HeLa and CaSki were obtained to analyze the effects of interference with ABHD11-AS1 and miR-1254 on the biological behavior of cervical carcinoma cells. Finally, the correlation of ABHD11-AS1 with miR-1254 was verified by double fluorescein reporter enzyme and immunocoprecipitation. ABHD11-AS1 was upregulated, and miR-1254 was reduced in serum and carcinoma tissues of cervical carcinoma patients (P < 0.05). The expression levels of the two were negatively correlated (P < 0.001). ABHD11-AS1 decreased and miR-1254 increased in serum of cervical carcinoma patients after treatment (P < 0.05). High ABHD11-AS1 and low miR-1254 had a close correlation with the poor prognosis of cervical carcinoma patients (P < 0.05). Silencing LncRNA ABHD11-AS1 could inhibit the activity of cervical carcinoma cells (P < 0.05), while inhibiting miR-1254 could promote the activity of cervical carcinoma cells (P < 0.05). ENCORI online website found that LncRNA ABHD11-AS1 and miR-1254 had binding sites. Bifluorescein reporter enzyme experiment found that ABHD11-AS1-WT fluorescence activity was inhibited by transfected miR-1254-mimics (P < 0.05). LncRNA ABHD11-AS1 accelerates proliferation, invasion, and migration of cervical carcinoma cells through targeted regulation of miR-1254, which may become the key to the treatment of cervical carcinoma.

STUDY AND ANALYSIS OF CERVICAL PAP SMEARS IN A MEDICAL COLLEGE HOSPITAL

Introduction: Cervical cancer is the second most common gynaecological cancer worldwide and the third leading cause of cancer-related mortality in the less developed countries. Cervical cancer may be prevented or diagnosed at early stages due to the easy accessibility and clinical evaluation of the cervix. A pap test is a simple, easy, painless procedure which can be carried out as an outpatient procedure to detect specic, nonspecic inammations, precancerous and cancerous lesions In our study we have analysed the results of PAP smears of women in all age groups and have tried to evaluate the prevalence of cervical lesions and the importance of cervical cancer screening. Material And Methods: Our study was conducted between October 2020 to JULY 2021 and patients who have visited the Gynaec OP during this period were included for this study. We received Pap smears from the Department of Obstetrics and Gynecology, stained the slides with Pap stain and studied the smears according to the new Bethesda System for Reporting Cervical Cytology 2014. Results: In our study, majority of the patients were in the age group of 41-50 years. Smears showing ASCUS were 14 , LSIL reports were 5, HSIL reports were 4. No Smears showed squamous cell carcinoma in our study. Reports in our study like many other studies has shown the importance of Pap smear test in screening cervical cancer. By conducting health camps, increasing health awareness and performing Pap smear screening programmes the incidence of cervical carcinoma can be decreased.

Cyto-histo correlation of conventional Pap smear with cervical biopsy in diagnosis of precancerous and cancerous lesions of cervix

Introduction: Carcinoma of uterine cervix is the third most common cancer among women worldwide and it contributes significantly to cancer related morbidity and mortality. The incidence of cervical carcinoma is incredibly high in developing countries (almost 80%) due to lack of proper knowledge. The extensive use of cervical screening with Pap smears has considerably increased the detection of precancerous and cancerous lesions of uterine cervix. Aims: To evaluate cyto-histo correlation of precancerous and cancerous lesions of uterine cervix and to calculate the sensitivity and specificity of Pap smear in diagnosing invasive malignancy. Materials and Methods: This was a retrospective observational study conducted in the Department of Pathology, Chirayu Medical College & Hospital, Bhopal from January 2013 to April 2018. All the cases reported in Pap smear as cervical intraepithelial lesions and invasive malignancies were retrieved. We also retrieved the same cases, if they had undegone cervical biopsy for correlation. Result: During the study period total 303 cases which were positive for intraepithelial lesions and malignancies were retrieved. Out of these 303 cases we excluded 23 cases because in these cases cervical biopsy had not been done. So in the final analysis 280 cases were included. Of the 280 Pap smears, maximum cases (33.92%) were reported as low grade squamous intraepithelial lesion (LSIL), followed by high grade squamous intraepithelial lesion (HSIL) (24.28%), atypical squamous cells of undetermined significance (ASCUS) (19.64%), atypical squamous cells – cannot rule out HSIL (ASC-H) (10%). We had 23 cases of invasive malignancy which includes 21 cases of squamous cell carcinoma (SCC) and 2 cases of adenocarcinoma. There were 11 cases of atypical glandular cells of undetermined significance (AGUS). We found that total numbers of concordant cases were 68.57% (192/280) and discordant cases were 31.43% (88/280). We also found that sensitivity and specif

Personalized Medicine and Cervical Screening: Development of Individualized Quantitative Risk Assessments for Cervical Adenocarcinoma and Adenocarcinoma in situ

Introduction: Cervical screening has decreased the incidence of cervical carcinoma around the world primarily by preventing cervical squamous carcinoma, with significantly less measurable protective benefits in prevention of cervical adenocarcinoma. In this study, we apply Bayesian modeling of cervical clinical, screening, and biopsy data from a large integrated health system to explore the feasibility of calculating personalized risk assessments on screened system patients for subsequent histopathologic diagnoses of invasive cervical adenocarcinoma (AdCa) or cervical adenocarcinoma in situ (AIS). Materials and Methods: Diagnoses of cervical AIS or AdCa rendered between 2005 and 2018 were identified in our large health system database with 1,053,713 cytology results, 354,843 high-risk (hr) human papillomavirus (HPV) test results, and 99,012 cervical histopathologic results. Using our continuously updated Bayesian cervical cancer screening model which includes clinical data, cervical screening results, and cervical biopsy results, we projected quantitative estimates of patients’ 5-year cumulative risk for cervical AIS or AdCa. Results: 161 patients were identified with AIS (ages 17–75, mean 37 years), and 99 patients had diagnoses of cervical AdCa (ages 26–91, mean 48 years). Quantitative Bayesian 5-year cumulative risk projections for diagnoses of cervical AdCa or AIS in patients with different cervical screening test and biopsy histories were determined. The highest patient risk projections for subsequent cervical AdCa and/or AIS histopathologic diagnoses were associated with prior cervical screening test results of HPV-positive atypical glandular cells. Prior squamous cytologic abnormalities were associated with lower risk estimates. Prior histopathologic diagnoses of squamous abnormalities also influenced quantitative risk. A prior histopathologic diagnosis of AIS was associated with a very low risk of subsequent AdCa, consistent with effective excisional treatment. AdCa risk was greatest in women aged 30–65 years with prior CIN3 biopsy results, whereas AIS risk was greatest in women <30. Conclusion: Prevention of cervical AdCa in screened patients remains a major challenge for cervical screening. Individualized risk projections for cervical glandular neoplasia reflecting patient age, prior cervical screening test results, and prior cervical biopsy history are feasible using Bayesian modeling of health system data.

Cytohistological correlation of conventional Papanicolaou smears in cervical neoplasia at a tertiary care hospital of Nepal

Background: Conventional Cervical Cytology is the most widely used cervical cancer screening test. The incidence of cervical carcinoma is incredibly high in developing countries due to lack of proper knowledge. The extensive use of cervical screening with Papanicolau smears had considerably increased the detection of precancerous and cancerous lesion of uterine cervix. Study was conducted to evaluate cytohistological correlation and to calculate concordance and discordance of Pap smear in detection of precancerous and cancerous lesions of uterine cervix.&#x0D; Materials and Methods: A total of 54 samples reported in Pap smear as cervical intraepithelial lesions and suspicious for invasive malignancies were selected and correlated with corresponding histopathological findings. It was an observational study done for a period of 18 months from November 2016 to May 2018 at UCMS-TH. All the statistical evaluation was done by using SPSS version 20.&#x0D; Results: During the study period 54 cases were evaluated. Atypical Squamous Cell of Undetermined Significance was the common abnormal findings in the Pap smear with frequency of 26 (48.1%). Out of total 54 cases of Pap smears, 30 (55.55%) were concordant while discrepancies occurred in 24(44.44%) cases with cervical biopsy.&#x0D; Conclusions: The study revealed a good correlation between cervical cytology and cervical biopsy. We also concluded that conventional Pap smear is a cost effective test for the early detection of precancerous and cancerous cervical lesions.

Importance of p16 and Ki67. Immunohistochemical Expression and in a Typical Immature Metaplasia (AIM)

Introduction: The term AIM was coined in 1983 to describe a squamous proliferation of the cervical transformation zone and glands associated with abnormal cytology and colposcopic findings. This condition may be a precursor of HPV integration. This subject is controversial because its biological and clinical significance are not well defined. Colposcopy suffers from the same diagnostic difficulties than Cytology and Pathology. The effect of gene inactivation in the cervical epithelium was investigated for the overexpression of p16 protein by Immunohistochemistry (IHC), which results in the loss of activation of Rb by the E7 protein of high-risk HPV. Objective: Investigate the use of biological markers, such as p16 and Ki67, which can be useful when diagnosing lesions with AIM. Material and Methods: A descriptive study of the IHC expression of p16 and Ki67 in 60 formalin-fixed paraffin-embedded cervical biopsies obtained from the private archive of a Pathology Laboratory, was conducted. Results: Negative cases for both p16 and Ki67 represented 69% of HPV lesions without dysplasia, whereas high-grade lesions (CIN III) were 100% positive for both p16 as Ki67. CIN I lesions were positive in 64% of the cases for both markers, and the rest were negative. CIN II lesions scored higher for p16 positivity, yielding positive results in 54% of the cases and 14% for Ki67. Conclusion: AIM is a complex entity can be associated with HSIL. The similarities between the AIM and LSIL can be consider a form of LSIL. p16 is a marker for HPV-induced dysplasia. We suggest cautious behavior, for the sake of diagnostic accuracy. Considering the increased incidence of cervical carcinoma and its relationship to HPV, we deem useful to use biological markers such as p16 and Ki67, that may allow to determine the possible progression of SIL to invasive carcinoma as more economical tool that may be more in tune with the socio-economic reality of Latin America and cost-effective, when compared to other more expensive techniques.

315P - Incidence of cervical carcinoma in different age groups and compare its pattern between nulliparous and women with multiple birth in tertiary care hospital in Nepal

315P - Incidence of cervical carcinoma in different age groups and compare its pattern between nulliparous and women with multiple birth in tertiary care hospital in Nepal

Malignancies Trends in a Hispanic Cohort of HIV Persons in Puerto Rico before and after cART.

The study describes the cancer trends in a Puerto Rican Hispanic HIV/AIDS cohort for three different time periods as defined by the availability of combination antiretroviral therapy (cART) in the Island: pre (1992-1995), early (1996-2002, and recent (2003-2009). AIDS and non-AIDS related malignancies risk, standardized incidence rate and one year mortality was evaluated in the cohort before and after cART. Of the 281 malignancies found in 265 persons; 72% were in men, 38% in injecting drug users and 42.3% were AIDS related cancers. AIDS related cancer standardized incidence rates decreased significantly in the cART eras; however, Kaposi's sarcoma and invasive cervical carcinoma incidence remained significantly higher in the cohort when compare to the general population. On the contrary, non-AIDS related cancer standardized incidence rates increased significantly in the cART eras, specifically those of the oral/cavity/pharynx, liver, anus, vaginal, and Hodgkin's and non-Hodgkin's Lymphomas. Around 50% of the persons with cancers were reported dead within the first year of their diagnoses without a significant variation during the cART eras. The higher incidence of Kaposi's sarcoma, invasive cervical carcinoma and non-AIDS related malignancies and their high mortality in the cART eras is suggestive of the role of oncogenic viruses, environmental agents, risky lifestyle behaviors and inadequate cancer prevention efforts that contribute and accelerate the risk of malignant transformation in these subjects. Aggressive intervention in the form of vaccines, risky practice reduction, early screening, early treatment and adequate risk reduction education needs to be incremented in this vulnerable population.

Evidence of disrupted high-risk human papillomavirus DNA in morphologically normal cervices of older women.

High-risk human papillomavirus (HR-HPV) causes nearly 100% of cervical carcinoma. However, it remains unclear whether HPV can establish a latent infection, one which may be responsible for the second peak in incidence of cervical carcinoma seen in older women. Therefore, using Ventana in situ hybridisation (ISH), quantitative PCR assays and biomarkers of productive and transforming viral infection, we set out to provide the first robust estimate of the prevalence and characteristics of HPV genomes in FFPE tissue from the cervices of 99 women undergoing hysterectomy for reasons unrelated to epithelial abnormality. Our ISH assay detected HR-HPV in 42% of our study population. The majority of ISH positive samples also tested HPV16 positive using sensitive PCR based assays and were more likely to have a history of preceding cytological abnormality. Analysis of subsets of this population revealed HR-HPV to be transcriptionally inactive as there was no evidence of a productive or transforming infection. Critically, the E2 gene was always disrupted in those HPV16 positive cases which were assessed. These findings point to a reservoir of transcriptionally silent, disrupted HPV16 DNA in morphologically normal cervices, re-expression of which could explain the increase in incidence of cervical cancer observed in later life.

Therapeutic Effectiveness of Large Loop Excision of Transformation Zone (LLETZ) in Management of Cervical Lesions

LLETZ is a simple, outpatient means of removing the transformation Zone or morbidity to the patient. The aim of our study was to evaluate the therapeutic effectiveness of LLETZ in management of cervical lesions. This prospective study was conducted at Department obstetrics & Gynecology Zenana Hospital, SMS Medical College, Jaipur from December 2014 to June 2015. The study includes all patients who attended colposcopy clinic with complaints of persistent leucorrhea, postcoital bleeding, intermenstrual bleeding and postmenopausal bleeding. We had 29 cases of chronic endocervicitis, 27 showed an inflammatory smear while 2 showed LGSIL. 3 patients showing HGSIL on pap smear showed CIN I on histopathology. This was false positive of Pap smear (6%). 1 patient of invasive squamous cell carcinoma showed HGSIL on pap smear. Thus LEEP was useful in diagnosing a case of invasive carcinoma which would have been missed with Pap smear alone. Also 3 patients of CIN II on biopsy had inflammatory (1) and LGSIL (2) on pap smear. LEEP (Loop Electrosurgical Excision Procedure) is a feasible management strategy for cervical lesions especially in developing countries like India where incidence of cervical carcinoma remains high because of ineffective screening and poor patient compliance for follow up.

Health economic evaluation of human papillomavirus vaccines in the developing countries: systematic reviews

Cervical carcinoma has brought huge burden on patients, especially in developing countries. Preventive vaccines could effectively reduce the incidence of cervical carcinoma. The high prices were one of the most difficult problem in introducing the vaccine in developing countries, so the cost-effectiveness and health financing of the vaccines should be carefully studied before incorporated into the national immunization program. Thus, researchers used mathematical models to predict the effects of HPV vaccines and to study the cost- effectiveness. In order to understand the current situation on the cost-effectiveness of HPV vaccines in the developing countries, a systematic searching of literature from PubMed, Elsevier Science Direct, Medline, ProQuest, CNKI and Wangfang Data was performed, this study aims to conduct a systematic review from aspects of project source, first author, research areas, research perspectives, prevention strategies, vaccine characteristics, cost-effectiveness.

Cervical cancer screening: current perspective

Cervical cancer is the second most common cancer among women worldwide. First priority to reduce deaths from cervical cancers is to implement high quality, fully organised screening programmes without delay. Knowledge about cervical cancer and Pap testing influences uptake of cervical cancer screening services. Screening and treatment for precancerous lesions is a more cost-effective intervention compared to management of invasive cervical cancer. Human papillomavirus is the etiologic agent of virtually all cases of cervical cancer worldwide. All women 30 years and older should be routinely screened &amp;screening should continue until the age of 65 years. By reducing the smear interval from 5 to 3 years in the age group &lt; 50 years, the risk reduction for cervical cancer could be improved. About 16% of the world′s total cases occur in india. At current incidence rates, the annual burden of new cases in India is projected to increase to 225,000 by 2025. However,the screening coverage in india is low upto 2.6-5 percent.Of all the screening tests available, the three main screening procedures commonly employed are Papanicolaou smears (Pap smears), visual inspection with acetic acid (VIA) and HPV testing . It has also been worked out that ‘once in a lifetime’ screening would result in reduction of 20-30% of the lifetime risk of cervical cancer. Health education is the most cost-effective approach in reducing the incidence of cervical carcinoma in developing countries like India.