Most Cases Of Cervical Cancer Research Articles

Awareness and Attitudes Among Parents of Females Aged 9-26 in Saudi Arabia Regarding Human Papillomavirus Vaccination.

Background Most cases of cervical cancer are caused by the human papillomavirus (HPV) infection, which can be prevented by vaccination. The HPV vaccine received approval in Saudi Arabia in 2010. Objectives This study aimed to examine the awareness and attitudes toward the HPV vaccine among parents of females aged 9-26 in Saudi Arabia and explore factors contributing to hesitancy or acceptance. Methods Conducted from November 2022 to June 2023 in Saudi Arabia, this cross-sectional study surveyed parents of females aged 9-26 using a self-administered questionnaire. Data collected included parental demographics, maternal vaccination status, awareness of the HPV vaccine, and attitudes toward it. Results Out of 551 participants, 445 (82.4%) were mothers. Most participants (331; 69.1%) had attained a university education, and approximately half (315; 57.2%) were employed. A total of 339 (61.5%) were aware of the HPV vaccine, 256 (46.5%) knew of its connection to cervical cancer, and 296 (53.7%) understood its preventive role. Among them, 230 participants demonstrated a good level of awareness, while 321 had a poor level. The majority (377; 68.4%) intended to vaccinate their daughters. Reasons for hesitancy among those unwilling included lack of awareness (234; 42.5%), insufficient information (206; 37.4%), fear of vaccines and needles (203; 36.8%), and conflicting medical opinions (165; 29.9%). Conclusion The current level of awareness regarding HPV vaccines within the general population is deemed satisfactory, with the majority expressing intent to vaccinate their daughters. Ongoing efforts are warranted to enhance awareness further, particularly by leveraging social media platforms and the expertise of trusted physicians and healthcare authorities. These endeavors are crucial for mitigating the preventable impact of HPV infection. Additionally, it is imperative to sustain immunization programs for HPV vaccines, ensuring streamlined vaccine administration.

Examining the Challenges and Strategies for Improving Cervical Cancer Screening in Nigeria

Background: Cervical cancer is one of the most treatable cancers when detected early and managed. Unfortunately, the mortality rate is projected to surge in Nigeria.Objective: This review aims to provide updated information on challenges and strategies for improving cervical cancer screening in Nigeria.Methods: In this review, scientific papers published in electronic databases including PubMed, Scopus, and Google Scholar were retrieved using search themes such as “cervical cancer”, “risk factors”, and “preventive methods” were examined.Results: The true prevalence of cervical cancer is underestimate in Nigeria because most cases of cervical cancer are not documented. Lack of awareness, cultural barriers, poor infrastructure, unfavorable perception, shortage of supplies, lack of partner involvement, provider-related factors, poor monitoring, and evaluation system were the major barriers that hinder cervical cancer screening service in Nigeria.Conclusion: Lack of awareness, unfavorable perception, problems with health system structure and process, and cultural conditions were major barriers in Nigeria. Hence, packages of intervention is necessary create awareness, provide essential equipment, increase access to health facilities, and strengthening follow up system is indispensable for service improvement by the government and non-governmental organizations, world health organization inclusive.International Journal of Human and Health Sciences Vol. 08 No. 01 Jan’24 Page: 22-31

HPV16 E6 promotes cell proliferation, migration, and invasion of human cervical cancer cells by elevating both EMT and stemness characteristics.

In most cases of cervical cancer, the high risk of the disease is caused by the human papilloma virus (HPV). Surgery or radiation usually benefits patients with early cervical cancer, while the metastatic one is uncurable and new therapeutic strategies and approaches are required. In this study, HPV16 E6 silence or overexpression were carried out to evaluate the possible mechanisms of HPV16 E6 function in cervical cancer cells with different HPV16 E6 expression background. HPV16 E6-positive cervical cancer cell Siha exerts significantly stronger cell invasion and migration potentials than the HPV16 E6-negative C33A cells. HPV16 E6 silence significantly weakened the potentials of cell invasion and migration, cell proliferation and stemness characteristic in Siha cells. Meanwhile, the overexpression of HPV16 E6 effectively promoted the cell proliferation and stemness characteristic in C33A cells. Our data also indicated a positive association between HPV16 E6 and the levels of epithelial to mesenchymal transition (EMT), and cell stemness. The ectopic expression of OCT4 could effectively reverse the inhibitory roles of HPV16 E6 silence on cell migration, invasion, and stemness in Siha cells. More interestingly, we found that HPV16 E6 might promote the OCT4 expression by impairing the direct binding of p53 on the promoter and activate its transcription. Taken together, our results indicated that HPV16 E6 could promoted the potential cell proliferation, migration, and invasion of human cervical cancer cells by modulating EMT and cell stemness. Our data provide a novel mechanism for how HPV16 E6 acts as a key risk factor for cervical cancer development and progression.

Attitude and practice on human papilloma virus infection and vaccination among students from secondary occupational health school: a cross-sectional study

ABSTRACT Cervical cancer (CC) is reported as the second-most common female cancer worldwide, of which 99% is caused by persistent human papillomavirus (HPV) infection. HPV vaccine protects against HPV infection and most cases of CC, which has only been introduced for a short time in mainland China. This study aimed to evaluate the attitude and practice related to HPV infection and vaccination among students at secondary occupational health school (SOHS) in China. We conducted a cross-sectional study in Southern China where data of 2248 participants were collected through questionnaires to estimate attitude and practice of students. Only 4.1% believed they were easily infected by HPV, 38.2% were willing to receive HPV vaccine and 30.8% intended to do regular screening of HPV infection in the future. Students in the second grade (OR = 1.51, 95%CI [1.25, 1.81]) and third grade (OR = 3.99, 95%CI [2.53, 6.27]) were more willing to take HPV vaccine compared to students in the first grade. Among the non-vaccinated participants, the most frequent reason for not receiving HPV vaccine was insufficient knowledge about HPV (91.1%). Characteristics of higher grade, personal education before enrollment and academic performance, medical specialty, history of sex experience and HPV vaccine and family history of other cancers were associated with higher attitude scores (p < .05). Considering the increasing prevalence of HPV infection and the need of improvement in attitude and practice toward HPV, more education about HPV infection and vaccination should be incorporated into school curriculum.

Mental illness is associated with advanced-stage cervical cancer in a vulnerable patient population

<h3>Objectives:</h3> Most cases of cervical cancer occur in patients who were either under-screened or had poor follow-up of abnormal results. Mental illness has been associated with an increased risk of morbidity and mortality from other chronic illnesses as well as decreased rates of cancer screening. The objective of this study was to investigate the impact of mental illness on screening, diagnosis and compliance to care in patients diagnosed with cervical cancer. <h3>Methods:</h3> A retrospective cohort study of patients diagnosed with cervical cancer at University Hospital/Rutgers New Jersey Medical School in Newark, NJ was performed. According to the US Census Bureau, the estimated population of Newark is 282,090 of which 50% of people are African American, 36% are Latino and 28% live below the poverty line, making Newark a vulnerable population. According to the NJ Department of Health and hospital discharge data in 2016, the crude rate of women with mental illness was 70% in Essex County where we are located.Baseline clinical data was analyzed to calculate descriptive statistics. Patients with and without mental illness were identified and separated into two groups. Group specific rates of screening, stage at diagnosis, and compliance were determined using Chi-Square or Fisher's exact tests. In order to account for potential confounding factors (age, race, body mass index, insurance status, substance use, smoking status, homelessness, prior medical history, HIV status, family history of cancer, history of pap smear testing, and type of cervical cancer), multivariable logistic regression modeling was used to complete adjusted analyses. All tests were two-sided and p<0.05 was statistically significant. <h3>Results:</h3> From 2012-2019, 166 patients with cervical cancer were identified, of which 15% had a history of mental illness defined as depression, anxiety and/or psychotic disorder. There were no differences in age, race, or primary language spoken. HIV (25% vs 6%, p=0.01), smoking (29% vs 9%, p=0.01), substance abuse disorders (13% vs 5%, p=0.01) and homelessness (21% vs 1%, p=0.001) were more prevalent in those with mental illness. Only 54% of those with mental illness underwent HPV/cytologic testing compared to 76% in the group without mental illness; however, this was not statistically significant (p=0.14). After adjusting for potential confounders, mental illness significantly increased the odds of diagnosis with advanced stage cervical cancer (OR = 6.3, 95% CI:1.5, 30.0). There were no significant differences with treatment compliance (p=0.99) or time to treatment initiation (p=0.97). <h3>Conclusions:</h3> Patients with cervical cancer and mental illness are more likely to be diagnosed at an advanced stage. This may be due to a decreased rate of screening in patients with mental illness. Although rates of screening were not significantly different, we suspect was secondary to the high proportion of mentally ill patients with an unknown screening history compared to patients without mental illness (17% vs 5%). Prospective study designs with larger sample sizes are needed to understand the association between mental health and cervical cancer. Additionally, collaboration between psychiatry, community health workers, and gynecology can help address barriers to screening and decrease missed opportunities in this population that has many touchpoints with healthcare.

A Scalable Manufacturing Approach to Single Dose Vaccination against HPV.

Human papillomavirus (HPV) is a globally prevalent sexually-transmitted pathogen, responsible for most cases of cervical cancer. HPV vaccination rates remain suboptimal, partly due to the need for multiple doses, leading to a lack of compliance and incomplete protection. To address the drawbacks of current HPV vaccines, we used a scalable manufacturing process to prepare implantable polymer–protein blends for single-administration with sustained delivery. Peptide epitopes from HPV16 capsid protein L2 were conjugated to the virus-like particles derived from bacteriophage Qβ, to enhance their immunogenicity. The HPV-Qβ particles were then encapsulated into poly(lactic-co-glycolic acid) (PLGA) implants, using a benchtop melt-processing system. The implants facilitated the slow and sustained release of HPV-Qβ particles without the loss of nanoparticle integrity, during high temperature melt processing. Mice vaccinated with the implants generated IgG titers comparable to the traditional soluble injections and achieved protection in a pseudovirus neutralization assay. HPV-Qβ implants offer a new vaccination platform; because the melt-processing is so versatile, the technology offers the opportunity for massive upscale into any geometric form factor. Notably, microneedle patches would allow for self-administration in the absence of a healthcare professional, within the developing world. The Qβ technology is highly adaptable, allowing the production of vaccine candidates and their delivery devices for multiple strains or types of viruses.

Presence of EBV and HPV Infection in Lymphoepithelioma-Like Carcinoma in the Uterine Cervix

Summary Squamous cell carcinoma is the cause in most cases of cervical cancer. A very unusual subtype of squamous cell carcinoma is lymphoepithelioma-like carcinoma, found in less than 1% of the neoplasm processes in the uterine cervix. Histologically it looks like a large nest of big-sized tumor cells with large vascular nuclei. Immunohistochemical markers used for LELC are p63, p16, human leukocyte antigen-D related (HLA-DR), and B-cell lymphoma 2. Even though it has aggressive morphological features, it has a better prognosis than most carcinoma cases of the uterine cervix. The condition is treatable, with a hysterectomy and bilateral salpingo-oophorectomy as the most common method. There are rare cases of pelvic lymph node dissection reported in the literature. There is data that lymphoepithelioma-like carcinoma is associated with the Ebstein-Barr virus and human papillomavirus. According to a survey by Tseng et al. and Chao et al., EBV is associated with LELC in Asian women, while HPV is associated with Caucasian women. Due to the small number of studies found in the literature, no conclusion can be drawn concerning the said viruses’ involvement in Asian and Caucasian patients.

2548. Provider Adherence to Cervical Cancer Screening in HIV Patient Populations

BackgroundAntiretroviral therapy has nearly normalized the life expectancy of people living with HIV (PLWH). However, malignancies still remain a major cause of morbidity and mortality in PLWH, and thus an important part of the clinical visit is age appropriate screening and referral to care, from Lancet 2019 for the poster. Most cases of cervical cancer occur in women who were either never screened or were screened inadequately. Over-screening for cervical cancer, on the other hand, leads to unnecessary stress and procedures, adding increased costs to the patient and to the healthcare system. The central aim of this project is to evaluate provider adherence at the Immunology Center (IC) to cervical cancer screening guidelines and to identify factors associated with over and underscreening.MethodsA retrospective chart review from January 1, 2015, to December 31, 2017 was performed. Study included HIV-seropositive women seen at the IC between April 2014 and June 2018. Exclusion criteria includes prior hysterectomy, abnormal cytology, cervical excision procedures, or other causes of immunosuppression.ResultsOf the 803 HIV-positive women identified, n = 262 met criteria for inclusion in the study. Overall adherence was 48%, with statistical significance found in cervical cancer screening between MDs and NPs, with an OR = 2.51 (P < 0.01). In regard to gender of provider, statistical significance in over screening was found between male and female providers, with an OR = 4.3 (P < 0.01), and in under screening between male and female providers, with an OR = 0.43 (P < 0.05). Over screening led to 44 excess pap smears over a 2-year period, yielding an excess cost of $6461. HPV co-testing was underutilized, with only one-third of encounters having HPV testing performed.ConclusionThis project gives us the opportunity to reeducate and retrain the clinical staff and practitioners providing cervical cancer screening at the Immunology Center. This is an ongoing quality improvement project, where adherence will be reassessed on a continuous basis at one-year intervals to ensure compliance with guidelines-based cervical cancer screening among female HIV seropositive patients at the Immunology Center. Disclosures All authors: No reported disclosures.

Cervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology.

Cervical cancer is a malignant epithelial tumor that forms in the uterine cervix. Most cases of cervical cancer are preventable through human papilloma virus (HPV) vaccination, routine screening, and treatment of precancerous lesions. However, due to inadequate screening protocols in many regions of the world, cervical cancer remains the fourth-most common cancer in women globally. The complete NCCN Guidelines for Cervical Cancer provide recommendations for the diagnosis, evaluation, and treatment of cervical cancer. This manuscript discusses guiding principles for the workup, staging, and treatment of early stage and locally advanced cervical cancer, as well as evidence for these recommendations. For recommendations regarding treatment of recurrent or metastatic disease, please see the full guidelines on NCCN.org.

Genetic polymorphisms in tumor necrosis factor alpha and interleukin-10 are associated with an increased risk of cervical cancer

Most cases of cervical cancer are the result of infection with specific high-risk types of human papillomavirus (HPV). Investigating the genetic basis of the host immune response, particularly cytokine function, could help further characterize the progression of cervical HPV infection into neoplasia. Prior studies have demonstrated a correlation between genetic variants of tumor necrosis factor alpha (TNF-α, TNF gene) and/or interleukin-10 (IL-10, IL10 gene) and cervical cancer susceptibility. However, some of the results have been contradictory. We sought to resolve these discrepancies by carrying out our study in a large cohort of Chinese women. In order to assess the association of TNF and IL10 genotypes with cervical cancer susceptibility, the polymorphisms in TNF (-238 G/A, -308 G/A) and IL10 (-592 C/A, -819 C/T, -1082 A/G) were genotyped and odds ratios for the genotype and allele frequencies between cervical cancer patients and healthy controls were calculated. Also, the functional relevance of these polymorphisms was evaluated using enzyme-linked immunosorbent assays (ELISAs) and in vitro lymphocyte proliferation assays. The TNF-238 AA genotype frequency was lower in patients than in controls (p < 0.05). TNF-308 AA, IL10-592 CA/AA, and IL10-819 CC/CT genotype frequencies were higher in cervical cancer patients than in controls (p < 0.05). The frequency of the TNF-238 A allele was significantly lower in patients, while the frequency of the -308 A allele was significantly higher (p < 0.05). No significant differences between patients and controls were found in the genotype or allele frequencies of IL10-1082 A/G (p > 0.05). Furthermore, the combinations of TNF-238 GA or GG and IL10-592 CC; TNF-238 GA or GG and IL10-592 CA or AA; TNF-308 AA and IL10-592 CC; and TNF-308 AA and IL10-592 CA or AA in cervical cancer patients were statistically significant (p < 0.0167). Upon stimulation with PHA, peripheral blood mononuclear cells (PBMCs) with the TNF-308AA genotype exhibited significantly higher proliferation rates, elevated IL-4, TGF-β levels, and lower IL-2 levels (p < 0.05). For IL10-592C/A, the AA and CA genotypes were significantly associated with higher proliferation rates, elevated IL-4 and IL-10 levels (p < 0.05). We also found that for TNF-308 G/A or IL10-592 C/A variants, the combination of TNF-308 GG or GA with IL10 CA or AA had an association with the severity of cervical cancer. Taken together, these results suggest that TNF-308 AA and IL10-592 CA/AA genotypes may increase susceptibility to cervical cancer by altering the immune response of an individual.

Effect of Productive Human Papillomavirus 16 Infection on Global Gene Expression in Cervical Epithelium.

Human papillomavirus (HPV) infection is the world's most common sexually transmitted infection and is responsible for most cases of cervical cancer. Previous studies of global gene expression changes induced by HPV infection have focused on the cancerous stages of infection, and therefore, not much is known about global gene expression changes at early preneoplastic stages of infection. We show for the first time the global gene expression changes during early-stage HPV16 infection in cervical tissue using 3-dimensional organotypic raft cultures, which produce high levels of progeny virions. cDNA microarray analysis showed that a total of 594 genes were upregulated and 651 genes were downregulated at least 1.5-fold with HPV16 infection. Gene ontology analysis showed that biological processes including cell cycle progression and DNA metabolism were upregulated, while skin development, immune response, and cell death were downregulated with HPV16 infection in cervical keratinocytes. Individual genes were selected for validation at the transcriptional and translational levels, including UBC, which was central to the protein association network of immune response genes, and top downregulated genes RPTN, SERPINB4, KRT23, and KLK8 In particular, KLK8 and SERPINB4 were shown to be upregulated in cancer, which contrasts with the gene regulation during the productive replication stage. Organotypic raft cultures, which allow full progression of the HPV life cycle, allowed us to identify novel gene modulations and potential therapeutic targets of early-stage HPV infection in cervical tissue. Additionally, our results suggest that early-stage productive infection and cancerous stages of infection are distinct disease states expressing different host transcriptomes.IMPORTANCE Persistent HPV infection is responsible for most cases of cervical cancer. The transition from precancerous to cancerous stages of HPV infection is marked by a significant reduction in virus production. Most global gene expression studies of HPV infection have focused on the cancerous stages. Therefore, little is known about global gene expression changes at precancerous stages. For the first time, we measured global gene expression changes at the precancerous stages of HPV16 infection in human cervical tissue producing high levels of virus. We identified a group of genes that are typically overexpressed in cancerous stages to be significantly downregulated at the precancerous stage. Moreover, we identified significantly modulated genes that have not yet been studied in the context of HPV infection. Studying the role of these genes in HPV infection will help us understand what drives the transition from precancerous to cancerous stages and may lead to the development of new therapeutic targets.

APOBEC-mediated genomic alterations link immunity and viral infection during human papillomavirus-driven cervical carcinogenesis.

Cervical cancer is one of the most frequently diagnosed cancers and is a major cause of death from gynecologic cancers worldwide; the cancer burden from cervical cancer is especially heavy in less developed countries. Most cases of cervical cancer are caused by persistent infection with carcinogenic human papillomavirus (HPV) genotypes 16 and 18. Non-resolving inflammation caused by HPV infection provides a microenvironment that facilitates cancer development. Molecular alterations during the process of HPV-induced carcinogenesis are characterized by DNA methylation within the HPV genome, promoter hypermethylation of tumor suppressor genes in the host genome, as well as genomic instability caused by viral DNA integrating into the host genome. Catalytic polypeptide-like apolipoprotein B mRNA editing enzymes (APOBECs) normally function as part of the innate immune system. APOBEC expression is stimulated upon viral infection and plays an important role in HPV-induced cervical cancer. APOBECs catalyze the deamination of cytosine bases in nucleic acids, which leads to a conversion of target cytosine (C) to uracil (U) and consequently a change in the single-stranded DNA/RNA sequence. APOBEC proteins mediate the complex interactions between HPV and the host genome and link immunity and viral infection during HPV-driven carcinogenesis. Understanding the effects of APOBECs in HPV-induced cervical carcinogenesis will enable the development of better tools for HPV infection control and personalized prevention and treatment strategies.

Risk factors and distribution of oncogenic strains of human papilloma virus in women presenting for cervical cancer screening in Port Harcourt, Nigeria

INTRODUCTION: human papilloma virus(HPV) accounts for most cases of cervical cancer with high risk HPV(hrHPV) genotypes largely responsible. The objective is to ascertain the distribution of oncogenic strains of human papilloma virus genotypes and predisposing risk factors in women presenting for cervical cancer screening in Nigeria. METHODS: a cross-sectional study of 80 women who presented for cervical cancer screening. The biodata of the participants, the presence of risk factors to HPV were recorded and hrHPV were identified using PCR technique. The information obtained was processed using the SPSS version 20 software. Results were presented in tables, test of significance and association done using student's t-test and Odds ratio with P value < 0.05 as significant. RESULTS: the age range of patients was 19-62 years with prevalence of hrHPV of 10%. HrHPV are more in patients with more than one life time sexual partner (OR 1.26,95%CI 0.13-29.99), multiple sexual partners (OR 1.55, 95% CI 0.28-8.70), early coitarche (OR 1.57, 95% CI 0.14-15.00) and previous STI (OR 150, 95%CI 9.53-1979. 62). Four hrHPV genotypes: 16, 18, 31 and 35 were detected. CONCLUSION: HPV genotype 18 was predominant in Port Harcourt, Nigeria. High risk sexual behaviours are associated with acquisition of hrHPV.

Political Pitfalls in Policymaking: The Texas HPV Vaccine Policy Saga

Political Pitfalls in Policymaking: The Texas HPV Vaccine Policy Saga Dan Bustillos In late 2005, while completing a post–doctoral fellowship at Baylor College of Medicine studying cancer disparities, I was asked to participate in a large–scale state health policy task-force on cervical cancer, a disease whose burden is [End Page 6] felt disproportionately by certain minorities and socioeconomic groups. Back then we were poised to have the unprecedented opportunity to dramatically reduce the incidence of cervical cancer due to the imminent approval and release of vaccines to immunize young girls from certain strains of the Human Papilloma Virus (HPV)–the sexually–transmitted pathogen responsible for most cases of cervical cancer. As a member of the Cervical Cancer Strategic Planning Initiative’s (CCSPI) Policy Work Group, I attended policymaking conferences convened in Austin, which were funded and organized by various agencies and organizations like the Texas Department of State Health Services and the Texas Cancer Council. But even more prominent and insistent in our policy taskforce meetings than the perpetually understaffed state agencies was the charismatic and influential presence of Women in Government (WIG), a large non–profit advocacy organization that includes many of the nation’s female legislators (including several close to then Texas governor Rick Perry). In fact, it had been at WIG’s behest, at its Cervical Cancer Summit in 2005, that Texas was singled out as the proving grounds for a push to enact liberal HPV vaccination policies into state law. And so it was that a large group of disparate stakeholders, health care professionals, grassroots activists, academics, cancer survivors, health economists and health policy wonks were all convened in Austin to prepare comprehensive policy recommendations on what Texas could and should be done once Merck’s Gardasil–projected to be the first FDA–approved HPV vaccine–became available in a few months. Beginning at the end of 2005, the taskforce worked to deliver thoughtful policy recommendations we would deliver to Rick Perry’s office. These sessions were well–financed, well–support staffed and filled with people from all over Texas with plenty of expertise, but since the actual vaccines were still in development at Merck and GlaxoS-mithKline (GSK), and little was publicly known about their relative safety and efficacy, we required access to unpublished data from the ongoing vaccine trials in order to base our recommendations on the best science available. This, it turned out, was not as difficult as it may sound. Although in private drug development the data generated by trials is usually a closely guarded trade secret until disclosure is required for patenting or for FDA approval, Merck didn’t wait for us to ask. Several Merck representatives were among the attendees at every CCSPI meeting. At first, I assumed that due to the pharmaceutical company’s obviously important role as the sole possessor of necessary information for our deliberation, Merck was asked to attend from the start. It wasn’t until later that I found out that Merck was in fact the prime mover behind this policymaking process, and their influence had begun well before the WIG summit in 2005. And although Merck’s obvious conflict of interest (the company stood to make many millions if not billions from any aggressive state vaccination policies) caused us to restrict Merck’s involvement to being a source of vaccine information when we asked for it, the pharmaceutical giant remained a constant presence throughout our policymaking. The Policymaking Process Although the morbidity and mortality associated with cervical cancer is not trifling, the policy work group decided early on not to recommend for mandatory vaccination of age–appropriate girls in Texas (the only group for which the new vaccine was expected to receive initial FDA approval). This decision was based on a variety of factors including the lack of long–term safety and efficacy data for the vaccine at the time, and the widespread belief among the policy taskforce members that a vaccine mandate bill would have little chance of passing the conservative legislature of Texas, a state that had seen very vocal criticism of the vaccine ever since it had been announced. Instead, we opted for a policy recommendation that showed...

Risk factors and distribution of oncogenic strains of human papilloma virus in women presenting for cervical cancer screening in Port Harcourt, Nigeria.

IntroductionHuman papilloma virus(HPV) accounts for most cases of cervical cancer with high risk HPV(hrHPV) genotypes largely responsible. The objective is to ascertain the distribution of oncogenic strains of human papilloma virus genotypes and predisposing risk factors in women presenting for cervical cancer screening in Nigeria.MethodsA cross-sectional study of 80 women who presented for cervical cancer screening. The biodata of the participants, the presence of risk factors to HPV were recorded and hrHPV were identified using PCR technique. The information obtained was processed using the SPSS version 20 software. Results were presented in tables, test of significance and association done using student's t-test and Odds ratio, with P value < 0.05 as significant.ResultsThe age range of patients was 19-62 years with prevalence of hrHPV of 10%. HrHPV are more in patients with more than one life time sexual partner (OR 1.26,95%CI 0.13-29.99), multiple sexual partners (OR 1.55, 95% CI 0.28-8.70), early coitarche (OR 1.57, 95% CI 0.14-15.00) and previous STI (OR 150, 95%CI 9.53-1979. 62). Four hrHPV genotypes: 16, 18, 31 and 35 were detected.ConclusionHPV genotype 18 was predominant in Port Harcourt, Nigeria. High risk sexual behaviours are associated with acquisition of hrHPV.

Prevalence of and risk factors for high-risk human papillomavirus infection: a population-based study from Hetian, Xinjiang, China

Human papillomavirus (HPV) infection contributes to most cases of cervical cancer, and HPV genotypes exhibit different distributions according to geographic region. This study evaluates the prevalence of HPV infection in Hetian Prefecture, Xinjiang, and establishes risk factors associated with high-risk HPV (HR-HPV) genotypes in this region. In this cross-sectional, population-based study, 883 healthy women 15-54 years of age were enrolled. All participants completed a questionnaire regarding sociocultural and sexual activity characteristics. Visual inspections with acetic acid, colposcopies and biopsies were performed using the Preventive Oncology International microbiopsy protocol for pathological diagnosis. Cervical epithelial tissue specimens were collected and tested for HPV using linear array assays. According to the results of HR-HPV infection status, individuals infected with HR-HPV were classified into one group, and the remaining individuals were classified into the control group. The risk factors for HR-HPF infection were analyzed. The participants included 66 women (7.47%) with HR-HPV, 10 women (1.13%) with low-risk HPV, and 14 women (1.59%) with HPV of unknown risk. The five most prevalent types of HR-HPV were HPV-16 (0.31%), HPV-51 (0.08%), HPV-31 (0.07%), HPV-58 (0.07%), and HPV-39 (0.06%). Vulvovaginal ulcers and vulvovaginal inflammation were found in 190 participants (21.52%) and 256 participants (28.99%), respectively. The HR-HPV and control groups significantly differed with respect to age at first marriage, number of marriages, and the presence of vulvovaginal ulcers and vulvovaginal inflammation (p<0.05). Based on this study, an immunization strategy targeting HPV-16 should be prioritized in Hetian Prefecture. These findings contribute to the understanding of HPV infection.

Study shows poor prognosis for HPV-negative cervical cancer

Human papillomavirus (HPV) is instrumental in the development of most cases of cervical cancer. While studies for HPV use highly sensitive tests, a negative result is nonetheless an infrequent finding, and it has been proposed that HPV-negative cervical cancer is an idiosyncratic category of cervical cancer.

Nurses Perceptions about Reasons for Women?s Non-utilisation of Cervical Cancer Screening Services in Malawi

Malawi offers free cervical cancer screening services in some government health institutions, but most cervical cancer cases are diagnosed during the late inoperable stages. This study attempted to identify, from nurse/midwives’ perspectives, reasons why most Malawian women fail to use cervical cancer screening services. A cross-sectional, exploratory, descriptive design was used and semi-structured interviews were conducted to collect data from the nurses. Purposively selected 14 nurse/midwives were interviewed. Malawian women’s non-utilisation of cervical cancer screening services was reportedly influenced by a shortage of nurse/midwives, inadequate health education, limited resources, unfavourable screening schedules, and geographic distances from these services. These identified factors need to be addressed to enable more women to use the available free cervical cancer screening services in Malawi, so that cervical cancer can get diagnosed during the early stages while effective treatment is available. Unless this happens, most cases of cervical cancer in Malawi will continue to be diagnosed during the terminal inoperable stages of cervical cancer.

Serum One-Carbon Metabolites and Risk of Cervical Cancer

Most cases of cervical cancer are associated with human papilloma virus (HPV) infection of high risk types. In folate deficiency, heterogeneous nuclear ribonucleoprotein E1 (hnRNP-E1) interferes with HPV16 viral capsid protein synthesis. We aimed to study the importance of 1-carbon metabolism in cervical carcinogenesis by examining serum vitamin B12 (cobalamin), homocysteine, folate levels, and the RNA and protein expression of HPV16 L1, L2, E6, E7, and to correlate them with hnRNP-E1 expression and HPV infection in normals, squamous intraepithelial lesions (SILs), and cervical cancer subjects. Serum cobalamin, folate, and homocysteine were estimated using kits, RNA by real time PCR and proteins by Western blotting. We observed that lower folate and vitamin B12 levels were associated with HPV infection. hnRNP-E1 progressively decreased from normals (100%) to SILs (75%) to cervical cancer (52.6%). The findings show that HPV16 E6 and E7 are overexpresed whereas HPV16 L1 and L2 are downregulated at mRNA and protein levels in cervical cancer as compared to normals and SILs. The results indicate that perhaps the reduced expression of hnRNP-E1 might be involved with the cervical cancer pathogenesis, with folate playing a role in the natural history of HPV infection.

Modeling and molecular dynamics of the intrinsically disordered e7 proteins from high- and low-risk types of human papillomavirus

Cervical cancer affects millions of women worldwide each year. Most cases of cervical cancer are caused by the sexually transmitted human papillomavirus (HPV). The approximately 40 HPV types that infect the cervix are designated high- or low-risk based on their potential to lead to high-grade lesions and cancer. The HPV E7 oncoprotein is directly involved in the onset of cervical cancer and associates with the pRb protein and other cellular targets that promote cell immortalization and carcinogenesis. This is the first description of the modeling and molecular dynamics analysis of complete three-dimensional structures of high-risk (HPV types 16 and 18), low-risk (HPV type 11), and HPV type 01 E7 proteins. The models were constructed by a hybrid approach using homology (MODELLER) and ab initio (Rosetta) modeling, and the protein dynamics were simulated for 50 ns under normal pressure and temperature (NPT) conditions. The intrinsic disorder of the E7 protein sequence was assessed in silico. Complete models of E7 were obtained despite the predicted intrinsic disorder of the N-termini from the high-risk HPV types. The N-terminal domains of all of the E7 proteins studied, even those from high-risk strains, exhibited secondary structure after modeling. Trajectory analysis of E7 proteins from HPV types 16 and 18 showed higher instability in their N-terminal domains than in those of HPV types 11 and 01; however, this variation did not affect the secondary structure during the simulation. ANCHOR analysis indicated that the CR1 and CR2 regions of HPV types 16 and 18 contain possible targets for future drug-discovery studies.