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PubMed2000

Cervical cancer screening in developing countries.

In developing countries, cervical cancer remains a clinical problem of public health proportions. Eighty percent of the approximately 400,000 new cases of cervical cancer each year occur in such settings. Primarily as a result of the introduction and success of screening programs, cervical cancer rates in developed countries have dropped remarkably. However, in most developing countries, screening programs are virtually nonexistent. Reasons for this relate primarily to lack of public awareness and the fact that screening via cytology is an untenable proposition for mass screening in such low-resource settings. Matching the resources available to provide cervical cancer screening in such settings requires alternative means of providing testing and treatment. Recent evidence indicates that, depending on local conditions and locally-made decisions, visual inspection of the cervix with acetic acid wash, coupled with a benign form of therapy, such as cryotherapy, could hold promise as a means of testing and treatment. By adapting resource-appropriate technologies and building local consensus regarding clinically driven public health approaches that are safe and feasible, the challenge of reducing the mortality from cervical cancer in developing countries can yet be met.

Journal Article↗
PubMed2001

History of tobacco use among Kentucky women diagnosed with invasive cervical cancer: 1997-1998.

An association between cigarette smoking and cervical cancer has been demonstrated by numerous epidemiologic studies. However, just because there is an association does not mean that there is an etiologic connection between tobacco use and cervical cancer, although some studies do indicate such a relationship. There are numerous potential explanations, including smoking as a behavior being associated with other behaviors that place women at increased risk of HPV infection. In a state like Kentucky, where the prevalence of smoking is so very high, one would expect that the disease burden from cervical cancer would also be high. A review of available data on invasive cervical cancer cases from the Kentucky Cancer Registry shows that this is indeed the case, with the incidence rate of invasive cervical cancer in Kentucky being as much as 40% higher than the SEER rate during the 1991-1998 time period. An analysis of available tobacco use history data from the KCR on women diagnosed with invasive cervical cancer during 1997-1998 shows that 61% of them indicated a history of tobacco use.

Female↗
PubMed2006

Prevalence and correlates of cervical cancer screening among injection drug users.

OBJECTIVE: Access to cervical cancer screening may be lower among lower income and socially disadvantaged populations. However, few studies have specifically examined factors associated with cervical cancer screening among socially marginalized populations, especially in settings with free health care systems. METHODS: The present study was conducted to examine the prevalence and correlates of cervical cancer screening among injection drug users. We examined rates of Papanicolaou (Pap) smear testing among female participants in the Vancouver Injection Drug Users Study (VIDUS). Univariate and logistic regression analyses were used to evaluate factors associated with cervical cancer screening. RESULTS: During the period from December 2004 to May 2005, 297 female injection drug users were seen. In logistic regression analyses, age (adjusted odds ratio [AOR]=0.70; 95% confidence intervals [CI] 0.53, 0.92, P=0.010), HIV infection (AOR=2.46; 95% CI 1.41,4.26, P=0.001), hepatitis C infection (AOR=0.25; 95% CI 0.09,0.71, P=0.010), and having visited a family physician in the prior six months (OR=3.10; 95% CI 1.58, 6.07, P=0.001) were independently associated with recent cervical cancer screening. CONCLUSIONS: After adjustment for regular physician visits, HIV infection was associated with elevated rates of cervical screening. This is reassuring, given the elevated risk of cervical cancer among this population. Interventions may be required to improve uptake of screening among older injection drug users and drug users infected with hepatitis C.

Adult↗
PubMed1997

Human papilloma virus 16-18 infection and cervical cancer in Mexico: a case-control study.

Cervical cancer (CC) is one of the principal public health problems in Mexico. The national mortality rate due to CC was estimated at 21.8 per 100,000 among women over 15 years old during 1994. Despite this high incidence little is known in Mexico about the risk factors for CC. The objectives of the study were to evaluate the association between CC and HPV types 16 and 18 in women living in Mexico City. From August, 1990 to December, 1992, a case-control study was carried out in the metropolitan area of Mexico City. HPV 16-18 types were determined in a sample of 148 CC cases and 204 controls randomly selected from a sample frame representative of the metropolitan area of Mexico City. Sixty cases corresponded to in situ CC and 88 cases to the invasive phase. Determination of HPV 16 and 18 types was done by polymerase chain reaction using primers specific to E6/E7. Results showed that 48.3% of in situ CC cases and 48.8% of invasive CC cases were positive for HPV 16 while only 13.2% were positive among the 204 controls. Association between HPV 16 infection in the in situ cancer cases had an estimated odds ratio (OR) of 5.17 (95% CI 2.60-10.51). In the invasive cervical cancer cases, association between HPV 16 infection and invasive CC in this sample had an OR of 3.84 (95% CI 2.04-7.22). For the total sample, the estimated OR was 5.48 (95% CI 3.07-9.62). In the total sample, those women with a strong positive reaction to PCR were associated with a large increase in the risk, OR of 38.0 (95% CI 8.66-167.1). The prevalence the HPV 18 was 6.7%, only observed in the invasive cervical cancer cases. At present there is general consensus that HPV is the principal causal agent in C C etiology. This study intends to contribute to the knowledge concerning the etiology of cervical cancer. However, it is necessary to consider that the single most effective tool in the reduction of mortality due to cervical cancer has been the Pap test. Secondary prevention has proven to be highly effective in other populations, and this should be viewed as a priority activity for all at-risk populations. Although a vaccine for HPV may be available in the near future its efficacy in primary prevention has yet to be demonstrated.

Adolescent↗
PubMed2003

The role of topotecan in the treatment of advanced cervical cancer.

Improvements in the early detection of cervical cancer have markedly reduced associated mortality rates over the past few decades; however, in patients diagnosed with cervical cancer the rates have remained unchanged for 25 years. Hysterectomy, alone or with radiotherapy, is effective in early-stage disease, with a high cure rate, but the treatment of advanced and recurrent cervical cancer (usually with radiotherapy and cisplatin) is suboptimal, with 5-year survival rates of 50.9 and 16.5% for patients with regional involvement or distant disease, respectively. There is therefore an unmet need for more effective treatments for patients with advanced disease, and a number of new chemotherapy agents and treatment strategies have been investigated in this setting. Promising results have been reported in phase II trials of the topoisomerase inhibitor I, topotecan. Response rates of up to 19% have been reported in patients treated with topotecan as a single agent and response rates of up to 54% have been achieved when this agent is used in combination chemotherapy regimens. Toxicity levels are similar to those observed in patients with relapsed ovarian cancer and are not significantly different from levels with other chemotherapy agents. This paper reviews the current management of advanced cervical cancer and summarizes the available data on the use of topotecan in this setting.

Antineoplastic Agents↗
PubMed2005

[Study on the relationship between genesis and development of cervical cancer and the infection of human papillomavirus type 16/18, human herpesvirus II and cytomegalovirus].

OBJECTIVE: To investigate the correlation between genesis and the development of cervical cancer and infection of human papillomavirus (HPV) type 16/18, human herpesvirus II (HSV- II) and cytomegalovirus(CMV). METHODS: Different viruses were determined by polymerase chain reaction in 156 specimens of uterine including cervix 43 cervical cancer specimens,47 cervical intraepithelial neoplasia (CIN) specimens, 56 cervicitis specimens and 10 normal cervix specimens. RESULTS: (1) Positive rates on different viruses: the positive rates of HSV- II, HPV16/18 and CMV were declining in the cervical cancer specimens, CIN specimens or CIN III specimens and CIN I - II specimens, with significant differences. (2)Positive rate and grading, staging and histogenesis of cervical cancer on different viruses as well as positive rates of HPV16/18 in II staging cervical cancer specimens were significantly higher than that in I staging cervical cancer specimens while positive rates of HPV16/18 and HSV- II in high differentiation of cervical cancer specimens were significantly higher than those with medium differentiation from cervical cancer specimens. Positive rates of CMV did not seem to correlate with positive rate of HSV- II and CMV was not correlated to grading, staging or histogenesis of cervical cancer. (3)Copies of infected virus, HSV-II and HPV16/18 showing cervical cancer>CIN> cervicitis while with CMV:cervical cancer>CIN. (4) There were mixed infections of different viruses as HPV16/18 + HSV- II > HPV16/18 + CMV seen in the study. CONCLUSION: HPV 16/18, HSV- II and CMV infection were closely related to the genesis of cervical cancer and quantity of viruses which might have played an important role in carcinogenesis of cervical lesions.

Adolescent↗
PubMed1994

Risk factors for invasive cervical cancer in Kenyan women.

BACKGROUND: Few epidemiological investigations of invasive cervical cancer have been conducted in Sub-Saharan African populations. METHODS: Using information collected as part of the hospital-based World Health Organization (WHO) Collaborative Study of Neoplasia and Steroid Contraceptives, we examined potential risk factors for invasive cervical cancer among Kenyan women. In all 112 women with histologically confirmed invasive cervical cancer diagnosed at the Kenyatta National Hospital, Nairobi, Kenya, between June 1981 and September 1988 and 749 control subjects were included in the present analyses. All women were interviewed regarding their medical and reproductive history, methods of birth control, and history of sexual relationships and sexually transmitted infections. Multiple logistic regression procedures were used to derive maximum likelihood estimates of adjusted odds ratios (OR) and 95% confidence intervals (CI). RESULTS: After adjusting for age, several factors were found to be associated with invasive cervical cancer. These include multiple sexual partners, early age at first sexual intercourse (OR = 1.9 and 2.6 for women reporting first intercourse at age 16-17 years and < 15 years, respectively, compared to women with first intercourse > or = 18 years), history of abnormal vaginal discharge (OR = 13.8, 95% CI: 8.3-23.0), and history of gonorrhoeal infection (OR = 3.2, 95% CI: 1.6-6.2). Low educational attainment and multiparity were also associated with the risk of invasive cervical cancer. Although the Papanicolaou smear has been extensively used as a screening method for cervical cancer in many countries, only three cases and four controls reported ever having a Papanicolaou smear (2.6% cases and 0.5% of controls). CONCLUSIONS: As has been observed in other parts of the world, cervical neoplasia in Kenya appears to be a late consequence of venereally transmitted carcinogenic agents.

Adolescent↗
PubMed1994

Early diagnosis of cervical cancers. Our experience at the Rural Cancer Registry, Barshi, India.

In the cervical cancer cases registered at the Cancer Hospital at Barshi, India during 1988-90, 99 of the 105 cases were clinically staged (Total number of cases registered: 136). The annual number of cases were too few for a comparison of stage distribution between the registry years. However, comparison of the proportions of early cases (FIGO Ib, IIa & IIb) in each year, with the corresponding proportion in a large series at the Tata Memorial Hospital (TMH) in Bombay in 1988, showed that the proportions of early cases in 1988 & 1989 (0.31 and 0.35 respectively) were similar to that (0.30) in TMH but in 1990, it (0.50) was significantly higher (P < 0.01). The shift to early stages observed three years after the inception of the Registry is most likely due to the registry activity which involved inter-personal contact with the community and motivation of the symptomatics to undergo a medical investigation. These activities were designed to overcome the adverse conditions for cancer registration prevailing in the rural population. It is suggested that to achieve early diagnosis similar activities be incorporated in the initial phase of a cervical cancer control programme in the country, where cervical cancer is not only the predominant cancer in women but also the cases generally present themselves in advanced stages.

Adult↗
PubMedDate not supplied

Determinants of cancer screening frequency: the example of screening for cervical cancer.

BACKGROUND: Cancer screening frequency should be based on the rate of progression of the disease and the sensitivity of the screening test. A common misconception is that a person's risk of getting the disease determines how often they should be screened. METHODS: We describe algebraically the theoretical interaction of disease progression rate and screening test sensitivity determining the portion of invasive cancers prevented by screening. After discussing the assumptions and limitations of the model, we apply this model to the example of screening for cervical cancer. Actual data from large screening programs assembled by the International Agency for Research on Cancer (IARC) are used to test the assumptions of the model. RESULTS: A simple formula can express the relation between disease progression rate, sensitivity of the screening test, screening frequency, and screening error. Disease prevalence does not figure in this equation. The IARC data suggest that, at least for cervical cancer, as screening frequency increases, incremental sensitivity of the test decreases or remaining undetected cases progress more rapidly so that anticipated benefits from more frequent screening are not realized. CONCLUSIONS: Rate of disease progression and sensitivity of the screening test are the proper determinants of cancer screening frequency. Because these factors can vary depending on screening frequency, however, the optimal screening interval for a particular cancer must be determined by clinical trials.

Data Interpretation, Statistical↗
PubMed2006

Proteasome inhibitor MG132 sensitizes HPV-positive human cervical cancer cells to rhTRAIL-induced apoptosis.

In cervical carcinogenesis, the p53 tumor suppressor pathway is disrupted by HPV (human papilloma virus) E6 oncogene expression. E6 targets p53 for rapid proteasome-mediated degradation. We therefore investigated whether proteasome inhibition by MG132 could restore wild-type p53 levels and sensitize HPV-positive cervical cancer cell lines to apoptotic stimuli such as rhTRAIL (recombinant human TNF-related apoptosis inducing ligand). In a panel of cervical cancer cell lines, CaSki was highly, HeLa intermediate and SiHa not sensitive to rhTRAIL-induced apoptosis. MG132 strongly sensitized HeLa and SiHa to rhTRAIL-induced apoptosis in a caspase-dependent and time-dependent manner. MG132 massively induced TRAIL receptor DR4 and DR5 membrane expression in HeLa, whereas in SiHa only DR5 membrane expression was upregulated from almost undetectable to high levels. Antagonistic DR4 antibody partially inhibited apoptosis induction by rhTRAIL and MG132 in HeLa but had no effect on apoptosis in SiHa. Inhibition of E6-mediated p53 proteasomal degradation by MG132 resulted in elevated levels of active p53 as demonstrated by p53 small interfering RNA (siRNA) sensitive p21 upregulation. Although p53 siRNA partially inhibited MG132-induced DR5 upregulation in HeLa and SiHa, no effect on rhTRAIL-induced apoptosis was observed. MG132 plus rhTRAIL enhanced caspase 8 and caspase 3 activation and concomitant cleavage of X-linked inhibitor of apoptosis (XIAP), particularly in HeLa. In addition, caspase 9 activation was only observed in HeLa. Downregulation of XIAP using siRNA in combination with rhTRAIL induced high levels of apoptosis in HeLa, whereas MG132 had to be added to the combination of XIAP siRNA plus rhTRAIL to induce apoptosis in SiHa. In conclusion, proteasome inhibition sensitized HPV-positive cervical cancer cell lines to rhTRAIL independent of p53. Our results indicate that not only DR4 and DR5 upregulation but also XIAP inactivation contribute to rhTRAIL sensitization by MG132 in cervical cancer cell lines. Combining proteasome inhibitors with rhTRAIL may be therapeutically useful in cervical cancer treatment.

Antineoplastic Agents↗
PubMed1999

'With the best of reasons': cervical cancer prevention policy and the suppression of sexual risk factor information.

Cervical cancer is a very common but largely preventable cancer. Despite considerable medical knowledge of risk and even causal factors, possible social-behavioural strategies for the primary prevention of cervical cancer have rarely been explored as a viable addition to cervical screening. We examine key policy documents and interview 18 key informants on cervical cancer prevention in New Zealand. Using a discourse analytic approach we identify and discuss two discourses (which we have labelled 'protectionism' and 'right to know') which inform positions on whether or not women should be provided with information regarding sexual risk factors for cervical cancer. Cervical cancer prevention policy in New Zealand, which largely reflects a protectionist discourse, suppresses sexual risk factor information and focuses exclusively on cervical screening. The right to know discourse informs an alternative position, which contends that women have a right to be informed about risk factors. We discuss these positions in relation to questions about women's rights, the principle of informed choice, and attempts to judge what is in women's 'best interests.'

Attitude to Health↗
PubMed2000

Knowledge, barriers, and motivators related to cervical cancer screening among Korean-American women. A focus group approach.

Cervical cancer is a significant health problem for Korean-American women. It currently is the number one female cancer diagnosed among women in South Korea. Despite this fact, Korean-American women have very low rates of cervical cancer screening. The purpose of this research were to gain an understanding of Korean women's knowledge about cervical cancer, and to identify major barriers to early screening for cervical cancer and the motivators for prevention and early detection. It is hoped that the findings will guide the development of community-based cervical cancer education and screening programs for adult Korean-American women. The health belief model (HBM) provided the theoretical basis for the study. A qualitative study with eight focus groups (n = 102) was conducted using 11 questions derived from the HBM. Focus group discussions revealed that there was misinformation and a lack of knowledge about cervical cancer. The women therefore were confused about the causative factors and preventive strategies related to cervical cancer. The findings showed that major structural barriers were economic and time factors along with language problems. Many participants were recent immigrants with no medical insurance and long work hours. The main psychosocial barriers were fear/fatalism, denial, and Confucian thinking. Participants stated that medical advice and education would influence them most to undergo a Pap test. Recommendations were made to reduce certain barriers and to increase knowledge and motivations.

Adult↗
PubMed2001

[Telomerase activity in cervical cancer and its precursor lesion].

OBJECTIVE: To study telomerase activity in cervical cancer and it's precursor lesion. METHODS: Thirty-six cervical cancer and 16 cervical intraepithelial neoplasia (CIN) specimens were measured for telomerase activity using TRAP-ELISA, and 11 normal cervix, 6 chronic cervicitis and 8 adjacent normal tissue specimens as controls. RESULTS: Mean telomerase activity in CIN, cervical cancer, and controls were 0.398 +/- 0.293, 1.580 +/- 0.819, 0.050 +/- 0.012. There was statistically significant difference among three groups (P < 0.01). Additionally, between patients with lymph node metastases (N+) and patients with tumor-free lymph nodes metastases (N-) a statistically distinct difference in telomerase activity was detected (P < 0.05). Telomerase activity was increasing with the advancing of histologic differentiated grade in invasive cervical cancer. However, no significant relationship was found between telomerase activity and tumor size, clinical stage, histology. CONCLUSIONS: Our data suggest that the reactivation of telomerase is an early event and may play an important role during cervical carcinogenesis and progression. It may be used as a tumor biomarker, helpful for the diagnosis of cervical cancer and CIN.

Adult↗
PubMed1987

'Avoidable mortality' from cervical cancer: exploring the concept.

The National Cancer Institute of the United States is encouraging research aimed at reducing 'avoidable mortality' from cancer. This article explores the meaning of the concept from a cancer-control perspective. Using cervical cancer as the focus of discussion, the author examines reference standards and social constraints that can help define the boundaries of avoidable mortality. The article considers the implications of voluntary participation in screening programs, the negative association between risk status and screening frequency, errors in collecting and interpreting Pap smears, improper and incomplete followup, and selected intervals for screening tests. To reach underscreened populations who are at high risk of cervical cancer, prevention strategists must create opportunities for intervention through innovative 'outreach' and 'inreach' programs. Inreach strategies exploit opportunities for cancer screening within the existing health-care process. Possibilities for reducing mortality from cervical cancer depend on more than the state of science. The likelihood of change is also a function of social priorities, social commitments, and the allocation of resources to social technologies that can effect change.

Adult↗
PubMed2003

[The cost of screening for breast and cervical cancer in France].

This article presents existing data on the cost of breast cancer and cervical screening programmes in France. The average direct cost of breast cancer screening was estimated at 57.77-60.51 Euro per woman attending for screening. Organisational costs account for 15-24% of total costs and the efficiency of existing screening programmes has improved over time. There is little available data on the cost of cervical cancer screening in France. The decentralised model of screening followed for both cervical and breast cancer programmes in France is more costly than the centralised model adopted by most other European countries. The best way to improve the economic value of screening programmes is to increase attendance rates. Attendance is currently inadequate for both screening programmes in France. For cervical screening, it is more cost-effective to increase screening attendance than to increase the frequency of screening. As long as screening attendance remains low, the impact of existing screening programmes will be suboptimal. Thus any new allocation of resources towards cervical and breast cancer screening in France should be assessed with caution.

Breast Neoplasms↗
PubMed2005

Serum vascular endothelial growth factor C (VEGF-C) as a specific biomarker for advanced cervical cancer: Relationship to insulin-like growth factor II (IGF-II), IGF binding protein 3 (IGF-BP3) and VEGF-A [corrected].

OBJECTIVES: An early non-invasive diagnosis of cervical cancer and its metastasis can save lives. We have shown that serum IGF-II levels can be effectively used for a specific early diagnosis of cervical cancer. Here, we shall determine if serum levels of vascular endothelial growth factors B and C (VEGF-A [corrected] VEGF-C) associated with vasculogenic and lymphogenic metastasis may be used for an early diagnosis of advanced metastatic cervical cancer and compare these levels with those of the serum IGF-II and IGF-binding protein 3 (IGF-BP3). MATERIAL AND METHODS: (a) Serum levels of IGF-II, IGF-BP3, VEGF-A [corrected] (VEGF(165)) and VEGF-C (ELISA kits) were determined in: 82 controls with normal Pap smears; 29 women with atypical squamous cells of undetermined significance (ASCUS) and normal cervical biopsy; 46 ASCUS and cervical intraepithelial neoplasia (CIN) on biopsy; 8 pre-therapy CIN-I; 23 successfully treated CIN-I; 75 persistent CIN-I; 14 CIN-II/III pre-therapy; 14 successfully treated CIN-II/III; 70 persistent CIN-II/III; 86 pre-therapy cervical cancer; 26 in early grades of cervical cancer; 21 in late grades of cervical cancer; 22 cervical cancer patients in remission; 50 persistent cervical cancer; 18 with ovarian cancer; and 57 with endometrial cancer. (b) Serial serum samples collected over 5 years in 5 women with progressing cervical cancer were also tested. (c) Serum and tissue VEGF-C were enumerated in 20 matched serum (ELISA) and tissue (semi-quantitative immunofluorescent antibody assay) samples from controls, early cervical cancer, late cervical cancer, ovarian cancer and endometrial cancer patients. Student's t test, chi-square analysis and linear regression analysis were used. RESULTS: (a) As anticipated, serum IGF-II levels were elevated as early as ASCUS with CIN on biopsy and continued to be elevated in CIN (all grades; pre-therapy and persistent) and cervical cancer (pre-therapy, early, late and persistent). Serum IGF-II levels were normal in ASCUS with normal biopsy, successfully treated CIN-I, II/III, cervical cancer as well as pre-therapy ovarian and endometrial cancers (therapy efficacy: P < 0.0001 by chi-square analysis). Serum IGF-BP3 showed a significant decrease with advancing disease. Serum VEGF-A [corrected] levels were the highest in pre-therapy, early, advanced and persistent cervical cancer, as well as in ovarian and endometrial cancers. Serum VEGF-C levels, on the other hand, were the highest in late and persistent cervical cancers, but not in ovarian or endometrial cancers. (b) In the 5 women with serial samples, the serum levels of the growth factors showed similar trends. (c) VEGF-C levels in serum and tissue were elevated in cervical cancers especially in advanced grades, while they were normal in serum and tissue from the controls and women with ovarian and endometrial cancers. There was a highly significant positive correlation between VEGF-C and IGF-II and a negative correlation between IGF-BP3 and VEGF-C (P < 0.0001). CONCLUSION: Serum IGF-II up-regulation is specific to cervical cancer and helps in the early diagnosis of malignant proliferation, while serum VEGF-C up-regulation appears to be a unique marker for an early diagnosis of cervical cancer metastasis. VEGF-C and IGF-II systems appear to be interrelated in cervical cancer, contributing to the early malignant cell proliferation and lympho-vascular metastasis. Serum IGF-BP3 and VEGF-A [corrected] appear to be common markers for all gynecological cancers.

Biomarkers, Tumor↗
PubMed2004

Pap screening and knowledge of risk factors for cervical cancer in Chinese women in British Columbia, Canada.

OBJECTIVE: Cervical cancer is a significant cause of mortality and morbidity for Chinese Canadian women, due in part to inadequate Pap screening. A community-based survey was conducted involving 528 Chinese immigrant women residing in British Columbia, Canada, in order to identify barriers and facilitators to Pap testing. This paper addresses the relationship between knowledge level about cervical cancer risk factors and Pap screening practices. DESIGN: Female trilingual Chinese interviewers conducted personal at-home interviews about knowledge of cervical cancer risk factors, history of Pap screening, sociodemographic and acculturation factors. RESULTS: The average summary score for knowledge about cervical cancer risk factors was 5.2/10, and knowledge level was significantly associated with the woman's educational level and the gender of the doctor providing usual care. Seventy-four per cent of respondents reported ever having received a Pap test, and 56% reported having received a test within the last two years. Respondents with the highest knowledge were more likely to have ever received a Pap test (OR 6.4, 95% CI: 2.6, 15.9), and to have recently received a test (OR 3.1, 95% CI: 1.4, 6.7). CONCLUSION: The average knowledge level about cervical cancer risk factors is low in Chinese Canadian women, especially among those with less education and who receive their usual care from a male doctor. Knowledge of these risk factors influences Pap screening behaviour. Culturally and linguistically appropriate education interventions addressing Pap testing and risk factors for cervical cancer are needed in the Canadian Chinese community. Educational resources are also needed for their primary care givers.

Adult↗
PubMed1997

A sero-epidemiological study of the relationship between sexually transmitted agents and cervical cancer in Honduras.

To investigate a possible cause-and-effect relationship between sexually transmitted diseases and cervical cancer, we performed a sero-epidemiological study on the presence of antibodies against a number of sexually transmitted agents (STAs) in patients with cervical cancer and their matched controls. In this study, we used serological techniques to investigate the presence of antibodies to cytomegalovirus, herpes simplex virus type 2, human immunodeficiency virus, Chlamydia trachomatis, Treponema pallidum and human papillomavirus (HPV) early protein E7 in sera from patients with cervical cancer, cervical intra-epithelial neoplasia and individually matched, healthy controls. The presence of antibodies to infectious agents other than HPV appeared not to be associated with risk of cervical neoplasia in either univariate or multivariate analysis. After adjustment for cytology, schooling and presence of HPV DNA in cervical scrapes, there was a significantly higher prevalence of antibodies to HPV-16 E7 protein in sera from patients with cervical cancer (OR = 3.6, 95% CI 1.0-12.9) than in healthy controls. The highest antibody prevalence was found among HPV-16 DNA-positive cervical cancer patients (33%). Our results indicate that in these study groups past infections with the STA considered seems to be of no apparent relevance for cervical carcinogenesis and that the HPV-16 anti-E7 response appears to be associated with cervical cancer.

Adult↗