Screening Of Cervical Lesions Research Articles

Cervical cancer screening using the Cervista high-risk human papillomavirus test: opportunistic screening of a hospital-based population in Fujian province, China.

ObjectivesThe Cervista® high-risk human papillomavirus (HR-HPV) test was evaluated as a primary screening method for cervical cancer in women aged ≥21 years and was compared with different screening and triage combinations.Materials and methodsA nested case–control study within the Fujian provincial Cervical Lesion Screening Cohorts was used to evaluate the Cervista test as the primary cervical screening method in a hospital-based population. Strategy 1 primarily screened using a cytology screen with HR-HPV testing used for triage. Strategy 2 primarily screened using cytology and HR-HPV co-testing. Strategy 3 primarily screened using HR-HPV testing and triaged HPV-positive women based on cytology. Strategy 4 primarily screened using HR-HPV testing and referred A9 pool HPV-positive women to colposcopy directly, whereas non-A9 HPV-positive women were triaged using cytology.ResultsThere were 10,183 women included in this study; 16.49% (1677/10,183) were HR-HPV-positive, 9.52% had abnormal cytology, and 9907 women were normal during followup. A total of 276 women were diagnosed with cervical intraepithelial neoplasia 2 or worse (CIN2+), 197 with CIN3 or worse (CIN3+), and 70 with cervical cancer. Moreover, 10.15% (20/197) women who were CIN3+ were identified as cytology-negative, while 8.63% (17/197) were HR-HPV negative (P>0.05). The cumulative risk rate for HPV–/cytology– was 0.836 (95% CI, 0.424–1.648) in CIN3+ cases. Strategy 4 yielded the highest sensitivity for CIN2+ or CIN3+ and the lowest positive predictive value for CIN2+ or CIN3+ among the four screening strategies.ConclusionThe Cervista HR-HPV test can provide a reliable and sensitive clinical reference for the cervical cancer primary screen.

Effectiveness of novel folate receptor-mediated staining solution detection (FRD) for cervical cancer screening.

Folate receptor-mediated staining solution detection (FRD) has been recently suggested as an effective tool in the cervical cancer screening. We aim to compare the accuracy of FRD to human papillomavirus (HPV) and thinprep cytology test (TCT) based on cytology-based biopsy.During May 2016 and December 2016, we recruited women who presented for routine cervical lesion screening. The eligible cases were nonpregnant women and not in the menstrual period, aging between 25 and 65. All eligible women were screened with TCT, HPV, FRD testing, and colposcopy.A total of 216 women include 137 (63.4%) cases of cervical inflammation, 27 (12.5%) cases of cervical intraepithelial neoplasia 1 (CIN 1), 51 (23.6%) cases of CIN 2, 34 (15.7%) cases of CIN 3, and 12 (5.6%) cases of cervical cancer. The sensitivity were 93.81%, 76.29%, 80.41% for HPV testing, TCT testing, and FRD testing, respectively. The specificities were 16.46%, 34.15%, and 68.29%, respectively. FRD has statistically significant higher specificity than HPV testing and TCT (both P < .05). However, no differences were found in sensitivity (both P > .05). The positive predictive value (PPV), negative predictive value (NPV), and Kappa consistency coefficient were 39.91%, 81.82%, and 0.08% for HPV testing, 40.66%, 70.89%, and 0.09% for TCT, and 60%, 85.5%, and 0.46% for FRD testing.FRD had favorable accuracy and efficacy in detecting cervical cancer, and therefore could be used as an effective screening tool for cervical cancer screening.

Menstrual Blood Human Papillomavirus DNA and TAP1 Gene Polymorphisms as Potential Biomarkers for Screening and Monitoring of Cervical Squamous Intraepithelial Lesion.

Human papillomavirus (HPV) is a known causative factor in the etiology of cervical cancer. HPV DNA genotyping was performed in menstrual blood (MB) collected in napkins from patients with cervical intraepithelial neoplasia (CIN), HPV infection and sexually active apparently normal subjects. In the same patient cohort, MB TAP1 I333V and TAP1 D637G gene polymorphisms were examined. The sensitivity, specificity, and positive and negative predictive values of HPV DNA in the detection of CIN or HPV infection were 83% (223 of 268), 98% (131 of 134), 99% (223 of 226), and 74% (131 of 176), respectively. Moreover, HPV DNA was found in 24% (28/118) patients who had loop electrosurgical excision procedure treatment and 0% (0/76) HPV infected or CIN1 patient with proven recovery. On the other hand, the risk of developing high-grade CIN was significantly reduced for AG and GG genotypes compared with AA genotype and for carriers with a G allele compared with those with an A allele for both polymorphisms. MB HPV DNA is a potential noninvasive marker for screening and monitoring of squamous intraepithelial lesion. Together with TAP1 I333V and TAP1 D637G gene polymorphisms, the combined test may be useful for stratifying high-risk patients for better follow-up strategies.

The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients with Cervical Cancer.

Despite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer. The European Society of Gynecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide. The ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of cervical cancer (23 experts across Europe). To ensure that the guidelines are evidence based, the current literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 159 international reviewers, selected through ESGO/ESTRO/ESP and including patient representatives. The guidelines cover comprehensively staging, management, and follow-up for patients with cervical cancer. Management includes fertility sparing treatment; stage T1a, T1b1/T2a1, clinically occult cervical cancer diagnosed after simple hysterectomy; early and locally advanced cervical cancer; primary distant metastatic disease; cervical cancer in pregnancy; and recurrent disease. Principles of radiotherapy and pathological evaluation are defined.

The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients With Cervical Cancer.

Despite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer. The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide. The ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of cervical cancer (23 experts across Europe). To ensure that the guidelines are evidence based, the current literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 159 international reviewers, selected through ESGO/ESTRO/ESP and including patient representatives. The guidelines cover comprehensively staging, management, and follow-up for patients with cervical cancer. Management includes fertility sparing treatment; stage T1a, T1b1/T2a1, clinically occult cervical cancer diagnosed after simple hysterectomy; early and locally advanced cervical cancer; primary distant metastatic disease; cervical cancer in pregnancy; and recurrent disease. Principles of radiotherapy and pathological evaluation are defined.

The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer

BackgroundDespite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer. ObjectiveThe European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide. MethodsThe ESGO/ESTRO/ESP nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of cervical cancer (23 experts across Europe). To ensure that the guidelines are evidence based, the current literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 159 international reviewers, selected through ESGO/ESTRO/ESP and including patient representatives. ResultsThe guidelines cover comprehensively staging, management, and follow-up for patients with cervical cancer. Management includes fertility sparing treatment; stage T1a, T1b1/T2a1, clinically occult cervical cancer diagnosed after simple hysterectomy; early and locally advanced cervical cancer; primary distant metastatic disease; cervical cancer in pregnancy; and recurrent disease. Principles of radiotherapy and pathological evaluation are defined.

Regular condom use tends to decrease cervical lesions in resident-commercial sex workers in Sub-Saharan Africa

BACKGROUNDCervical lesions are abnormalities seen in tissues and cells examined from the uterine cervix. These abnormalities are on the increase and are ignored; thereby constituting major health problems in resident commercial sex workers (CSWs) who temporarily reside in brothels for sex business. Hence, we investigated the associations between behavioural risk factors and cervical lesions in resident commercial sex workers. METHODSWe conducted a cross-sectional study among 119 resident commercial sex workers using questionnaires as the data gathering tool, liquid-based cytology for cervical lesions screening, and microscopy for examination of slides. Statistical analyses were conducted using Epi- Info™ version 6.4 and STATISTICA (StatSoft, version 5, 2009 Edition, Atlanta, GA 30329-4027 USA). Data were analysed using multivariate and simple logistic regression analyses, while the level of significance was set at p £0.05. RESULTSThe behavioural risk factors, like smoking and hard drugs, alcohol intake, commercial sex duration, client’s daily patronage and sex frequency were not significant apart, but regular condom use tends to decrease the cervical lesions in CSWs (OR=0.91;95% C.I. 0.92-1.06), including anal and oral sex (OR = 0.99 (95% C.I. 0.29-3.60). The patterns of cervical lesions further showed acute and chronic cervicitis with a prevalence of 10.1%, including low-grade squamous intraepithelial lesion (LSIL) and atypical squamous cells of undetermined significance (ASCUS). We recorded 8/12 (66.7%) for acute cervicitis, 4/12 (33.3%) chronic, and 82.4% negative. CONCLUSIONWe suggest that behavioural risk factors are associated with cervical lesions and that regular condom use tends to decrease cervical lesions among resident CSWs.

Dual p16 and Ki-67 Expression in Liquid-Based Cervical Cytological Samples Compared to Pap Cytology Findings, Biopsies, and HPV Testing in Cervical Cancer Screening: A Diagnostic Accuracy Study

Objective: Our objective was to verify the sensitivity and specificity of dual immunocytochemistry staining for p16 and Ki-67 in liquid-based samples (the “dual” assay) for cervical lesion screening, compared to biopsy findings and human papillomavirus (HPV) DNA molecular detection. Study Design: Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values for the “dual immunocytochemistry assay” were calculated and compared to histopathological results and to high-risk HPV DNA detection in adult women or teenagers submitted to cervical cancer screening. Results: A total of 151 women were included. The majority (96.2%) of those with negative dual assay results had lower biopsy grades (p < 0.001). Women with cytology results suggestive of cervical cancer had positive dual immunocytochemistry assay results more frequently (p < 0.001), and these positive results were also significantly associated with biopsy findings (p < 0.001) and with high-risk genotype HPV infection (p = 0.007). Specificity and PPV for the dual assay were 0.972 (0.855–0.999) and 0.800 (0.284–0.995), respectively, and 1.000 (0.590–1.000) and 1.000 (0.631–1.000) for HPV detection. Conclusions: The dual immunocytochemistry assay had high specificity and PPV. It reveals a persistent HPV infection, avoiding the need for new tissue collections for biopsies or hybrid capture.

New progress in the early screening of cervical precancerous lesions

Cervical cancer is one of the most common gynecological malignancies which seriously threatens the health of women.How to further expand the scope of screening and improve the sensitivity and specificity of screening and optimize screening programs are the key points of cancer prevention and treatment.At present, the screening methods that are commonly used at home and abroad include cervical smear cytology, human papillomavirus (HPV) detection, molecular biology detection and genetic genetic testing.Cervical smear cytology has high specificity and low sensitivity, the sensitivity of HPV detection is high, but the specificity is low, and the molecular biological detection and genetic testing has high specificity and high sensitivity, but due to the lack of large quantities of clinical samples, and the higher detection cost, they are still in the test study stage. Key words: Cervical cancer; Human papillomavirus; Human telomerase gene; DNA methylation

The clinical value of HPV E6/E7 and STAT3 mRNA detection in cervical cancer screening

ObjectiveTo explore the value of human papillomavirus (HPV) E6/E7 and signal transducer and activator of transcription 3 (STAT3) mRNA detection in the screening of cervical lesions. Methods192 patients with abnormal ThinPrep cytology test (TCT) results and/or high-risk HPV infection were screened to identify possible cervical lesions in cases. Diagnoses were confirmed by histopathology. Fluorescence in situ hybridization (FISH) was performed to detect and qualify the mRNAs of HPV E6/E7, STAT3, and Survivin in cervical exfoliated cells. In addition, the performance of separate and combined mRNA detection methods were compared with TCT, HR-HPV DNA schemes respectively. Results1. Compared with HPVE6/E7 and STAT3 mRNA methods, Survivin mRNA assay had poor specificity (Sp), Youden index (YI) and concordance rate. 2. HPV E6/E7, STAT3, and STAT3 + HR-HPV methods had the best Sp, concordance rate and positive predictive value (PPV) for cervical lesions screening and atypical squamous cells of undetermined significance (ASCUS) triage. For screening of high grade squamous intraepithelial lesions or greater (HSILs+), no difference was observed in the Se of mRNA detection methods in comparison with that of TCT, HR-HPV and TCT + HR-HPV, whereas the false positive rate (FPR) decreased by 41.48%/55.99%/17.19% and the colposcopy referral rate reduced by about 20.00%/25.00%/11.17%. For triage of women with ASCUS, no difference was observed in the Se of mRNA detection methods as compared to that of HR-HPV (χ2 = 1.05, P > 0.75), while the FPR decreased by 45.83%/37.50%/41.66% and the colposcopy referral rate reduced by 32.42%/22.60%/25.28%, respectively. The Se, YI, and PPV of the combined methods increased in comparison to each method alone. 3. Compared with the TCT + HR-HPV method, HPV E6/E7 + STAT3 method had perfect Sp (95.92%) and PPV (95.40%) for screening HSILs+, the FPR and colposcopy referral rate decreased by 31.06% and 22.48% respectively. Conclusions1. The expression of HPV E6/E7 and STAT3 mRNA confirmed using FISH assay is expected to be a new method and molecular marker for cervical lesions screening. Survivin mRNA was excluded due to its poor performance. 2. HPV E6/E7, STAT3, and STAT3 +HR-HPV assays could be new approaches for cervical cancer screening and ASCUS triage, and the efficiency of combined screening program was better than that of a separate one. 3. HPV E6/E7 + STAT3 regimen is expected to be a diagnostic strategy for cervical lesions.

Neuro-fuzzy implementation for cervical lesions screening in commercial sex workers

This study proposed a neuro-fuzzy model for cervical lesions (CL) detection in commercial sex workers. Our aim is to formulate an understandable and practicable model for CL screening of commercial sex workers (CSWs) operating in rural communities in Edo State, Nigeria. The specific objective is to confirm the levels of precision of the neuro-fuzzy model using liquid-based cytology (LBC) method. The adaptive neuro-fuzzy inference system (ANFIS) implementation was used for screening and LBC techniques for confirmation of the ANFIS outcomes. The classification performance of ANFIS model had 98.7% precision with a training error of 1.1652 and basic testing error 1.255. LBC showed eight cases of CL (15.4%) from 259 prostitutes and was age and duration of commercial sex-dependent (P < 0.05). The present ANFIS implemented model is excellent for routine screening of the CSWs, while LBC remains a gold standard for CL diagnosis worldwide.

Neuro-fuzzy implementation for cervical lesions screening in commercial sex workers

This study proposed a neuro-fuzzy model for cervical lesions (CL) detection in commercial sex workers. Our aim is to formulate an understandable and practicable model for CL screening of commercial sex workers (CSWs) operating in rural communities in Edo State, Nigeria. The specific objective is to confirm the levels of precision of the neuro-fuzzy model using liquid-based cytology (LBC) method. The adaptive neuro-fuzzy inference system (ANFIS) implementation was used for screening and LBC techniques for confirmation of the ANFIS outcomes. The classification performance of ANFIS model had 98.7% precision with a training error of 1.1652 and basic testing error 1.255. LBC showed eight cases of CL (15.4%) from 259 prostitutes and was age and duration of commercial sex-dependent (P < 0.05). The present ANFIS implemented model is excellent for routine screening of the CSWs, while LBC remains a gold standard for CL diagnosis worldwide.

Challenges and strategies in cervical cancer screening and management of cervical lesions

Challenges and strategies in cervical cancer screening and management of cervical lesions

Assessment on application value of combination of TCT, HPV, c-MYC and hTERC genes to screen cervical cancer

Objective To investigate the application value of combination of thinprep cytologic test (TCT), human papilloma virus (HPV), c-MYC and human chromosome telomerase gene (hTERC) genes to screen cervical cancer. Methods A total of 230 cases of the study objects was detected with TCT and HP, respectively. Amplification of c-MYC and hTERC genes was tested with fluorescence in situ hybridization (FISH) method. The histopathological results were the gold standard, and the sensitivity, specificity and accuracy of cervical intraepithelial neoplasia (CIN) Ⅱ/Ⅲ and squamous cell carcinoma (SCC) were compared with the four combined detection. Results Of 230 screened patients, there were 124 cases of TCT positive, 155 cases of HPV positive, c-MYC gene amplified in 118 cases, and hTERC gene amplified in 128 cases. When TCT, HPV, c-MYC, and hTERC were used alone, the highest sensitivity was HPV (84.5%), the highest specificity was c-MYC (97.6%), and the highest accuracy was hTERC (85.2%). When the three indexes were used in coordination with each other, the sensitivity and accuracy of TCT+ HPV+ hTERC were the highest (98.6% and 90.9%), and the specificity of TCT+ c-MYC+ hTERC was the highest (79.3%). When the four indexes were used together, the sensitivity was 98.6%, the specificity was 72.0%, and the accuracy was 89.1%. Conclusions Combined examination can improve the sensitivity and accuracy of screening cervical lesions, and the three combination of TCT+ HPV+ hTERC had the best effect, and c-MYC gene detection had the highest specificity. Key words: Biopsy; Papillomaviridae; Genes, myc; Telomerase; Uterine cervical neoplasms/DI

To analyse the histopathological results of patients with HPV16/18 positive and colposcopic suspicious lesions

Objective: To explore the value of histopathologic diagnosis after colposcopy for high-risk HPV16/18 positive patients with negative cytology or atypical squamous cells of undetermined significance (ASCUS) for early screening of cervical lesions. Methods: A retrospective study of cervical histopathologic diagnosis in the HPV16/18 positive patients received colposcopy evaluation before got the histology was carried out between January 2014 and January 2016. The cytology of the patients should be negative or ASCUS. A total of 337 patients with age from 21 to 65 years old were enrolled, including 214 patients with negative cytology, and 123 patients with ASCUS. Results: (1) The results of pathology were as follows: 63 (18.7%) cases inflammation, 89 (26.4%) cases cervical intraepithelial neoplasia (CIN)Ⅰ, 182 (54.0%) cases CINⅡ-Ⅲ and adenocarcinoma in situ (AIS), and 3 (0.9%) cases minimal invasive cancer (stageⅠa1). The incidence of CINⅡ and above cervical lesions was higher in the patients with ASCUS (71.5%, 88/123) than that in the patients with negative cytology (45.3%, 97/214; χ(2)=24.876, P<0.01), and it was higher in the patients with HPV16 positive (64.4%, 150/233) than that in the patients with HPV18 positive (30.3%, 27/89; χ(2)=31.388, P<0.01). There was statistically significant difference among the different age group in which the patients of 20-29 years old was 69.3% (52/75), 30-39 years old was 55.1% (75/136), 40-49 years old was 44.8% (30/67) and 50 years old and above was 47.5% (28/59; χ(2)=16.512, P=0.032). (2) Among the patients with negative cytology, the incidence of CINⅡ and above cervical lesions in the patients with HPV16 positive was higher than that in the patients with HPV18 positive [54.8% (80/146) vs 26.0% (20/77) ; χ(2)=16.930, P<0.01]. The incidence was also higher in the patients with HPV16 positive than that in the patients with HPV18 positive [76.5% (78/102) vs 55.6% (15/27) ; χ(2)=4.642, P=0.031] among the patients with ASCUS. (3) Compared to the patients diagnosed inflammation or CINⅠ, the patients diagnosed CINⅡ and above cervical lesions had higher infection rate of HPV16, lower infection rate of HPV18, higher incidence of ASCUS, and smaller parities (all P<0.05). A multifactor analysis was carried out, the results showed that HPV16 positive and ASCUS might be independent risk factors to predict the incidence of CINⅡ and above cervical lesions (P<0.01) . Conclusions: The incidence of cervical precancerous lesions is high in the women with HPV16/18 infection. Patients with HPV16 infection are more likely to have the CINⅡ and above cervical lesions than patients with HPV18 infection. Patients with HPV16/18 infection are suggested to be directly transferred to clinic of colposcopy, and then getting the histology selectively, which would be help to early detection of the cervical precancerous lesions.

Spectrum of abnormal epithelial lesions of cervix in a tertiary care teaching hospital in South India

Introduction: Cervical cancer is the leading cause of death in developing countries like India. Cervical cytology by papanicolaou (pap) smears is an effective means of screening for cervical premalignant and malignant lesions. Aim: To study the role of pap smear in detecting premalignant and malignant lesions of cervix and to determine the prevalence of various lesions. Materials and Methods: This was a retrospective study of 1030 conventional pap smears reported from the Department of Pathology, Government Medical College, Anantapuramu. The time period was from October 2014 – September 2016. Results: In our study out of 1030 cases, inflammatory smears were reported in 713 cases (69.22%), Epithelial cell abnormalities were found in 71 smears(6.89%), atypical squamous cells of undetermined significance (ASCUS) in 27 (2.62%), AGUS in 0.10%, LSIL in 25 cases (2.43%), HSIL in 1.26% cases and invasive squamous cell carcinoma in 5 (0.48%) cases.

Application of liquid based cytolgy combined with human papillomavirus DNA typing detection in screening for cervical precancerous lesions

目的 探讨液基细胞学(TCT)联合人类乳头瘤病毒(HPV)DNA分型检测在宫颈癌前病变筛查中的应用价值，旨在为早期预防和精准治疗提供参考。 方法 选取经TCT检测且诊断不能明确意义的非典型鳞状上皮细胞(ASCUS)及以上的患者367例，再行HPV-DNA分型检测。对于可疑病灶行宫颈活检诊断。 结果 检出HPV患者117例，HPV菌株135株，检出阳性率为36.78%。除HPV73外，其余22种亚型均被检出，高危型HPV亚型以HPV16、HPV18、HPV58、HPV53、HPV68较为常见，低危型HPV亚型以HPV6、HPV11较为常见。按TCT诊断分组，ASCUS、LSIL、HSIL、SCC组的HPV阳性率、高危型HPV阳性率均依次增高(χ2＝9.72、10.15，均P<0.01)；LSIL、HSIL、SCC组的高危型HPV阳性率均高于低危型HPV阳性率(χLSIL2＝10.25、χHSIL2＝21.43、χSCC2＝16.36，P<0.01)。 结论 TCT可检测宫颈已经发生的细胞学改变，HPV基因诊断可明确HPV-DNA亚型，TCT联合HPV-DNA分型检测可能是宫颈癌前病变筛查的较好方案，对宫颈癌前病变早期预防和精准干预治疗具有良好的临床指导意义。

Screening, prevalence, and risk factors for cervical lesions among HIV positive and HIV negative women in Swaziland

BackgroundCervical Cancer (CC) is the number one cancer among women in sub-Saharan Africa. Although CC is preventable, most women in developing countries do not have access to screening.MethodsThis cross-sectional study was conducted to determine the prevalence and risk factors for cervical lesions using visual inspection with acetic acid (VIA) among 112 HIV positive and 161 negative women aged 18–69 years.ResultsThe presence of cervical lesions was greater among HIV positive (22.9%) than HIV negative women (5.7%; p < 0.0001). In logistic models, the risk of cervical lesions among HIV positive women was 5.24 times higher when adjusted by age (OR 5.24, CI 2.31–11.88), and 4.06 times higher in a full model (OR 4.06, CI 1.61–10.25), than among HIV negative women. In the age-adjusted model women who had ≥2 lifetime sexual partners were 3 times more likely (OR 3.00, CI 1.02–8.85) to have cervical lesions compared to women with one lifetime partner and the odds of cervical lesions among women with a history of STIs were 2.16 greater (OR 2.16, CI 1.04–4.50) than among women with no previous STI. In the fully adjusted model women who had a previous cervical exam were 2.5 times more likely (OR 2.53, CI 1.06–6.05) to have cervical lesions than women who had not.ConclusionsThe high prevalence of HIV infection and the strong association between HIV and cervical lesions highlight the need for substantial scale-up of cervical screening to decrease the rate of CC in Swaziland.

Knowledge, attitudes, practices and willingness to vaccinate in preparation for the introduction of HPV vaccines in Bamako, Mali

Although screening for pre-cancerous cervical lesions and human papilloma virus (HPV) vaccination are accepted and effective means to prevent cervical cancer, women in Mali have limited access to these interventions. In addition, cervical cancer prevention by HPV vaccination has been controversial in some settings. To reduce cervical cancer prevalence and increase HPV vaccine uptake, it is important to understand the level of knowledge about cervical cancer screening and practices related to vaccination in at-risk populations. In this study, the level of knowledge about HPV and cervical cancer and attitudes towards vaccination were assessed among 301 participants (male and female, adults and adolescents) in a house-to-house survey in two urban neighborhoods in Bamako, Mali. The survey was combined with a brief educational session on HPV. Prior to the education session, overall knowledge of HPV infection and cervical cancer was very low: only 8% knew that HPV is a sexually transmitted infection (STI). Less than 20% of women had ever consulted a gynecologist and less than 3% had ever had cervical cancer screening. After hearing a description of HPV vaccine, more than 80% would accept HPV vaccination; fathers and husbands were identified as primary decisions makers and local clinics or the home as preferred sites for vaccination. This study provides information on STI knowledge and vaccine acceptance in Bamako, Mali in 2012, prior to the introduction of HPV vaccination.

Meta-analysis of TP73 polymorphism and cervical cancer.

The aim of this study was to investigate the tumor protein p73 (TP73) G4C14-A4T14 polymorphism and to perform a meta-analysis to assess TP73 expression in cervical cancer and precancerous tissue. Articles containing data regarding TP73 status in cervical cancer patients and healthy controls were retrieved from PubMed, EMBASE, Cochrane, Chinese Biomedical Literature, and China National Knowledge Infrastructure databases. Then, the quality of the studies was evaluated according to inclusion and exclusion criteria. Odds ratios between the case and control groups were used as an effect evaluation index and the RevMan 5.0 software was employed to carry out the meta-analysis. Three independent investigations including 8452 cases of cervical cancer and 8326 healthy controls were included in our study following the application of inclusion and exclusion criteria. PCR genotyping revealed that the TP73 GC/GC genotype produced a 193-bp product, while the AT/AT genotype produced a 270-bp fragment, and GC/AT genotype samples produced two fragments of 193 and 270 bp. Meta-analysis showed that TP73 expression in cervical cancer was significantly higher than that in normal cervical squamous epithelium (P < 0.05). This elevated expression may play an important role in the occurrence and development of cervical cancer. Therefore, TP73 testing might be useful in the screening and diagnosis of cervical cancer and precancerous lesions.