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PubMed1992

Disease-related needs of black patients with cervical cancer.

The high incidence of cervical cancer amongst South African black women is complicated by late presentation for treatment as well as by misconceptions and ignorance which adversely affect the quality of their lives. The aim of the research was to determine the disease-related needs of patients suffering from cervical cancer which would serve as a basis for planning on providing for these needs. Needs for the following were identified: Education on early detection in the community. Education on nutrition and hygiene. Information on and assistance in obtaining financial relief by means of subsidized transport and disability pensions.

Adult↗
PubMed2003

Gemcitabine in cervical cancer.

OBJECTIVE: Recurrent and advanced cervical cancers are associated with high mortality and a lack of effective treatment options, especially for women who are poor candidates for surgery or radiation therapy. The broad clinical effectiveness and low toxicity of gemcitabine in other human malignancies suggest that it might be useful in treating cervical tumors. METHODS: Fifteen phase I/II clinical trials on the use of gemcitabine, both as a single agent and in combination with cisplatin, in patients with recurrent or advanced carcinoma of the cervix were reviewed. Data from studies in which gemcitabine was used in combination with radiotherapy for induction therapy and with cisplatin for neoadjuvant chemotherapy were also evaluated. RESULTS: Although single-agent gemcitabine was generally inferior to cisplatin, when used concurrently with cisplatin and/or radiation therapy, objective response rates were high and survival was prolonged. The drug also showed promise when used with cisplatin as neoadjuvant therapy. CONCLUSIONS: Initial studies suggest that gemcitabine may be useful in the management of recurrent or advanced cervical cancer when used concurrently with cisplatin. Accordingly, a large phase III study will compare cisplatin/gemcitabine with the current standard, and further evaluation of gemcitabine appears to be warranted in conjunction with radiotherapy and in the neoadjuvant setting.

Antimetabolites, Antineoplastic↗
PubMed2003

[Study on the correlation between the different papillomavirus type and telomerase in cervical cancer].

OBJECTIVE: To define a correlation between different human papillomavirus (HPV) types and telomerase activity in cervical cancer. METHODS: Telomerase activity was detected by TRAP-PCR, and different HPV type was determined by PCR in 83 cervical cancer, 47 cervical intraepithelial neoplasia (CIN) and 10 normal cervix cases. RESULTS: With regard to positive rates of telomerase and HPV 16/18: the results were cervical cancer > CIN > normal cervix, CIN III > CIN I, II; with regard to HPV 6/11 positive rate: the results showed CIN I, II > CIN III. Positive rates of telomerase cervical cancer and HPV were bearing on grading and staging, but they did not correlate with histologic subtypes. Positive rate of HPV 6/11 had nothing to do with grading, staging and histologic patterns. On expression strength of telomerase and HPV 16/18: the results showed cervical cancer > CIN, CIN III > CIN I, II. Regard to HPV 6/11'expression strength: the results showed CIN I, II > CIN III, CIN > cervical carcinoma. CONCLUSION: HPV 16/18 infection seemed to have played an important role in carcinogenesis of cervical lesions by activation of telomerase.

Female↗
PubMed1996

Cervical cancer screening in Bali: a public health issue.

Cervical cancer is the most common cancer in women in developing countries. Regarding cervical cancer in Bali, we sought to determine the incidence, to evaluate existing preventive and screening programs, to identify the population being screened, and to examine the methods of testing. The records of the Udayana Teaching Hospital pathology laboratory and Cancer Registry were reviewed, retrospectively. The incidence of cervical cancer in Bali is 7/100,000. There has already been a substantial increase in the number of Papanicolaou tests (PT) from 767 in 1990 to 1,355 in 1992. In 63% of these tests the results were Class II, indicating a need for attention to infection. Cervical intraepithelial neoplasia has a statistically significant increase with age. The number of PT performed peaks in the 35-44 year age group, with a sharp decline thereafter. Fifty-four percent of PT are performed in the capital city, which has only 20% of the female population. Bali Hindu women make up 94% of the female population, but receive only 81% of PT, while Muslim women make up 5% of the population and receive 12% of PT. Seventy-eight percent of PT contain no endocervical cells. There has already been a promising increase in the number of PT performed in Bali. Public health promotion efforts as well as outreach programs should be expanded, perhaps using the Banjar system, to reach older and rural women. Collectors of Pap smears should be instructed on the importance of endocervical sampling.

Adolescent↗
PubMed1989

Cervical cancer in Jewish women.

Because of the known low incidence rate of cervical cancer in Jewish women, less than appropriate attention has been focused on this type of malignancy in Jewesses. We have summarized our experience with 144 cases of cervical cancer diagnosed during 25 years in South Israel. In recent years a remarkable, although not statistically significant, increase in the number of patients with cervical cancer could be observed. Only two of ten patients were diagnosed at preinvasive stage. In contrast with previous reports we did not find women of Asian and African origin to be overrepresented, but patients from these origins were more often diagnosed at a higher stage than were patients of European origin. Adenocarcinoma accounts for almost 19% of the cervical cancer in premenopausal women. A very low rate of early detection of cervical cancer and a trend of rising incidence of cervical cancer in Jewish women urgently require a reevaluation of health care policy. Large-scale screening programs, perhaps initially in defined high-risk groups are needed.

Adenocarcinoma↗
PubMed2004

The cytotoxicity of chemotherapy drugs varies in cervical cancer cells depending on the p53 status.

Metastatic cervical cancer remains a clinical problem. The development of more efficient treatment modalities and the optimal use of chemo- and radiotherapy require better understanding of their impact on regulation of cell survival and apoptosis, but the issue is insufficiently explored. Human papillomavirus (HPV) E6 protein is present in nearly all cervical cancers, targeting the p53 tumor suppressor protein for degradation. We studied the role of p53 in mediating the cytotoxic effects of 31 chemotherapy compounds. SiHa cervical cancer cells, carrying wild type (wt) p53 and HPV16 genome, were stably transfected with dominant negative p53 (DDp53) or ectopic HPV16 E6 in order to inhibit p53 function. The effects of chemotherapy drugs in these cells were compared to the effects in cells retaining endogenous residual p53 activity. Twenty-ight out of 31 drugs reduced the amount of E6 mRNA, but only some induced marked p53 activation. In clonogenic cell survival experiments, the presence of DDp53 and ectopic E6 either increased or decreased cytotoxicity, depending on the drug. The decrease of E6 mRNA was necessary, but not sufficient event in the p53 activation by chemotherapy. The impact of p53 on clonogenic cell survival varied between 0-60%, indicating that p53 plays an important, but not crucial role in response to chemotherapy. The finding that chemosensitivity varies depending on the p53 status may have clinical implications, since early stage cervical cancer cells usually carry wt p53, whereas p53 mutations are frequently found in advanced disease.

Antineoplastic Agents↗
PubMed1983

[Treatment of recurrent cervical cancer].

The questionnaire about recurrent cervical cancer of uterus were taken in 57 hospitals and treatments to 370 recurrent cases in National Institute of Radiological Science were studied. Our results were as follows. 1) About 50% of recurrent cases were detected within one year after primary treatments. Local recurrents were superior in cases of surgery as initial treatment, distant metastasis in cases of radiation. 2) Five Y.S.R. of 370 cases was 17.3% that of 105 operation cases as initial treatment was 26.7%. 3) Five Y.S.R. according to the sites of recurrence were 26.5% in vaginal stump, 6.7% in intrapelvis, 2.2% in lung metastasis, 5.5% in bone metastasis. 4) Five Y.S.R. according to the secondary treatments were 30% in operation, 16.4% in radiation, 6.9% in chemotherapy. 5) The principals of combined therapy to recurrent cervical cancer were presented.

Brachytherapy↗
PubMed1999

Detection of high-risk cervical intraepithelial neoplasia and cervical cancer by amplification of transcripts derived from integrated papillomavirus oncogenes.

Cervical cancer emerges from cervical intraepithelial neoplasia (CIN) induced by high-risk HPV (HR-HPV) infections. However, the vast majority of CIN lesions regresses spontaneously, and only a few lesions persist or progress to invasive carcinoma. On the basis of morphological criteria, it is not possible to differentiate high-grade lesions that will regress or persist from those that inevitably will progress to invasive cancers. In most cervical carcinomas, human papillomavirus (HPV) genomes are integrated into host cell chromosomes and transcribed into mRNAs encompassing viral and cellular sequences. In contrast, in early preneoplastic lesions, HPV genomes persist as episomes, and derived transcripts contain exclusively viral sequences. Thus, detection of HPV transcripts derived from integrated HPV genomes may specifically indicate both CIN lesions at high risk for progression as well as invasive cervical cancers. Here, we established a protocol for the amplification of papillomavirus oncogene transcripts (APOT) from cervical specimens that allows us to distinguish episome- from integrate-derived HPV mRNAs. Cervical swab and biopsy samples from 549 patients attending outpatient clinics for cervical dysplasia were screened for the presence of HPV DNA, and 155 samples that were positive for either HPV type 16 (n = 143) or 18 (n = 12) were subjected to the APOT assay. In samples derived from normal cervical epithelia (n = 19) or low-grade cervical lesions (CIN I, n = 10), no integrate-derived HPV transcripts were found. In contrast, in 1 (5%) of 22 samples derived from CIN II lesions, in 10 (16%) of 64 samples from patients with CIN III lesions, and in 35 (88%) of 40 samples from patients with cervical cancer, integrate-derived HPV transcripts were detected. Thus, detection of integrate-derived HPV transcripts in cervical swabs or biopsy specimens by the APOT assay points to advanced dysplasia or invasive cervical cancer.

Biopsy↗
PubMed1997

Purity and passion: risk and morality in Latina immigrants' and physicians' beliefs about cervical cancer.

This paper examines how physicians' beliefs about risk factors for cervical cancer compare with Mexican and Salvadoran immigrant women's views (hereafter Latina immigrants). Between August 15, 1991 and August 15, 1992, we conducted ethnographic interviews with 39 Mexican immigrant women, 28 Salvadoran immigrant women, and 30 physicians in northern Orange County, California. Physicians and Latina immigrants converge on their beliefs that sexual behavior is a predominant risk factor for cervical cancer. They diverge, however, on their reasons. Latina immigrants' perceptions of health risks are embedded in a larger set of cultural values centering around gender relations, sexuality, and morality. Latina immigrants also emphasized men's behavior as risk factors. Physicians' views, on the other hand, are largely based on the epidemiology of cervical cancer risk factors. They emphasized beginning sexual relations at an early age, multiple sexual partners, and infection with sexually transmitted viruses. Some physicians, however, displayed moral interpretations of the sex-based risk factors for cervical cancer through the use of the culturally-loaded term "promiscuous" in place of "multiple sexual partners," through specific references to morality, and through characterizations of women at risk for cervical cancer. Both the physicians and the Latina immigrants in our study paid considerably less attention to socioeconomic factors. Our results have important implications for physicians who provide health care for Latina immigrants. Physicians should be clear to point out that women need not be "promiscuous" to get cervical cancer.

Adult↗
PubMed2004

[Expression of PDCD5 in tissues of normal cervix, CIN I-III and cervical cancer].

OBJECTIVE: To investigate the expression of PDCD5 in tissues of normal cervix, CIN I-III, cervical cancer and explore the relationship between PDCD5 and cervical cancer. METHODS: After we defined the most fitful condition, tissues from 18 cases of normal cervix, 19 of CIN I, 18 of CIN II, 20 of CIN III and 18 of cervical cancer were defined by indirect immunohistochemical technique. Positive expression rates and intensity of PDCD5 protein were investigated by observing under microscope and analyzing with computer imaging technique. The results were analyzed with one-way anova. RESULTS: The results of immunohistochemical staining showed that the percentage of strong positive cells in normal cervical tissue and CIN I were significant higher than those of CIN II, CIN III and cervical cancer. On the whole of the condition of immunohistochemical staining, the expressions of PDCD5 were downregulated along the progression of cervical atypical epithelia, but that in CIN I was upregulated. The ODs of normal cervix,CIN I-III,cervical cancer were 0.322, 0.366, 0.287, 0.252, and 0.206 respectively. The intensity of each group showed obvious differences. CONCLUSION: We found that the expression of PDCD5 was upregulated in CIN I and downregulated in CIN II, CIN III and cervical cancer. It suggests that PDCD5 is an important apoptosis regulating factor in the occurrence of cervical cancer.

Adult↗
PubMedDate not supplied

Interrelation between Western type cancers and non-Western type cancers as regards their risk variation in time and space. IV. Hormonal transition of Japanese women from the pro-cervical cancer age through the pro-endometrial cancer age to the pro-hypogonadism age.

Chronological trend of urinary steroid excretions in Japanese women was investigated during the period of June 1972 to August 1986 using healthy women of urban and rural origins, patients with breast cancer and patients with either cervical cancer or endometrial cancer. The excretions of 14 neutral steroids were estimated by gas liquid chromatography, and the obtained data were tentatively correlated with the epidemiological backgrounds. In the course of the chronological transition from the 1st stage (1972-1974) to the 2nd stage (1975-79), the urinary steroid pattern of Japanese women with and without cancer experienced a common change to produce specific deviations that were in agreement with the hormonal characteristics of a pill user or of an endometrial cancer patient. At the 3rd stage (1980-86), patients with either cervical cancer or endometrial cancer were distinguished from 1st stage controls by non-specific depression of all androgens, progestins and corticosteroids in urine. Throughout the whole period, both the risk for cervical cancer and the reproductive activity (birth rate) were found to decrease continuously in Japanese women. Evidence was presented to suggest that the above deterioration of the hormonal environment in Japanese women could be related to the stress of modern life rather than to defects in the diet. On the basis of the above findings, the 1st, 2nd and 3rd stages of our investigation were tentatively termed the pro-cervical cancer age, the pro-endometrial cancer age and the pro-hypogonadism age. The relation between the chronological change of urinary steroids and that of the epidemiological background was analyzed from the view point of population ecology.

Age Factors↗
PubMed1996

Establishment and characterization of a human-papillomavirus negative, p53-mutation negative human cervical cancer cell line.

A human cervical cancer cell line, CX, was established from a patient with squamous cell carcinoma of the uterine cervix. The CX cells were epithelial in morphology with relatively large vesicular nuclei, and prominent nucleoli. Cytoplasmic organelles were generally sparse but tonofilaments were relatively abundant. The cells grew as a compact sheet with close membrane approximation interconnected by desmosome-like junctions. CX cells contained cytokeratin, but not vimentin. Elevated levels of squamous cell carcinoma antigen and carcinoembryonic antigen were detected in the cell supernatants. Population doubling time was estimated to be about 20 h. CX cells were not able to grow in soft agar and not tumorigenic in nude mice. Chromosome analysis revealed that CX cells were heterogeneous and mainly had a female diploid karyotype. Unlike cervical cancer cell lines published previously, CX cells were demonstrated to be human papillomavirus-negative, p53 mutation-negative. Based on the distinct characteristics, CX cell line may prove to be a useful tool for the study of human cervical carcinogenesis.

Antigens, Neoplasm↗
PubMed1990

Bleomycin, vincristine, and mitomycin C (BOM) as second-line treatment after failure of cis-platinum-based combination chemotherapy for recurrent cervical cancer.

Seventeen patients with recurrent cervical cancer were prospectively treated with a combination of bleomycin, vincristine, and mitomycin C (BOM). All patients had previously failed a cis-platinum-containing combination regimen. There were no complete responses. Four patients had partial responses, six patients had stable disease, and seven patients had no response. The median length of survival for responders was the same as that for nonresponders (5 months). More than 50% of patients experienced significant toxicity. The combination of bleomycin, vincristine, and mitomycin C appears to be ineffective as a second-line chemotherapy regimen against recurrent cervical cancer previously treated with cis-platinum.

Adult↗
PubMed1996

Cervical Cancer among Asian American Women: A Neglected Publica Health Problem?

PURPOSE OF THE PAPER: Relatively little attention has been paid to cervical cancer control in Asian American populations. We summarize available cervical cancer incidence and mortality dat, present information on levels of Pap testing use, and review factors that may be associated with cervical cancer screening participation. METHODS: We reviewed the literature pertaining to cervical cancer and Pap testing among Asian populations in North America. PRINCIPAL FINDINGS: Cancer registry data suggest that women from Southease Asia have a nearly five­fold increased risk of invasive cervical cancer (when compared to non&shyHispanic White women). Filipino and Korean populations also have elevated risks. The excess invasive cervical cancer burden appears to be concentrated among women aged 40 and older. Pap testing use by Asians is less than for all toher racial/ethnic groups in the U.S., and recent studies suggest that over one­third of Vietnamese immigrants have never been screened. Barriers to Pap testing participation by less acculturated Asian women include a lack of familiarity with Western preventive concepts, a lack of knowledge concerning cervical cancer, embarrassment in association with gynecologic exams, the role of women in some Asian cultures, the cost of health care, and language difficulties. CONCLUSIONS: There is a considerable need for ethnoculturally appropriate cervical cancer control programs targeting Asian American populations. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: This paper is relevant to Asian American women from East, South, Southeast, and Island Asia.

Journal Article↗
PubMed1994

Cervical intra-epithelial neoplasia and invasive cervical cancer in black and white patients.

The relative incidences of cervical intra-epithelial neoplasia (CIN) and invasive cervical cancer were studied in black and white patients at the academic hospitals of the University of the Orange Free State. A statistically highly significant difference was found between black and white patients, with a higher incidence of invasive cervical cancer than stage III CIN (CIN III) in black patients and a higher incidence of CIN III than invasive cervical cancer in white patients (P = 0.000092; 95% confidence interval -0.355-(-)0.128). The time interval between the peak incidence of CIN III and that of invasive cervical cancer was found to be shorter in black than in white patients. These distressing findings emphasise the urgent need for a national cervical cytological screening programme to decrease the incidence of invasive cervical cancer. This serious yet preventable disease is still very prevalent in South Africa, especially among black women.

Adult↗
PubMed2006

Cervical cancer: a call for political will.

Cervical cancer kills over a quarter of a million women worldwide on an annual basis, with 80% of these deaths occurring in developing countries. Cytology-based screening programs, widely used in industrialized countries, are difficult to implement in low-resource settings. Non-cytological methods for screening and treatment have been developed and studied over the last decade. Given the barriers to widespread, good quality screening and early treatment, the most promising new prevention strategy will be the introduction of a vaccine to prevent human papillomavirus infection, the cause of cervical cancer. Understanding women's health-seeking behaviors is critical to successful dissemination and uptake of both screening and vaccine prevention strategies.

Developing Countries↗
PubMed2004

Human papilloma virus type 16 infection and the early onset of cervical cancer.

Human papilloma viruses (HPV), particularly type 16, have been associated with cervical cancer. It has been noted that the average onset of cervical cancer is occurring in younger women coupled with a higher prevalence of cervical HPV infection. However, the correlation between HPV 16 infection and the early onset of cervical cancer is still unclear. We hypothesize that HPV infection is an indicator of early onset of cervical cancer. To test this hypothesis, cervical smears from 197 women were evaluated by the polymerase chain reaction for HPV 16. These data revealed that the HPV 16-positive women were significantly younger than the HPV 16-negative women. Moreover, the average age of HPV 16-positive women with CIN 3 or invasive cancer was significantly younger compared with the other groups. These data clearly suggest that HPV 16 infection is a significant risk factor for the progression for cervical cancer in a young population of women.

Adult↗
PubMed1982

Review of the epidemiology of cervical cancer in the Pacific Basin.

Cervical cancer, despite its declining incidence in the developed countries, is still an important cancer in the less-developed world. The mortality and incidence trends for some of the countries in the Pacific Basin are presented. Among the high-risk communities and populations are Colombia (Cali), New Zealand (Maoris), El Paso, Texas (Latin Americans), California (blacks), Hawaii (Hawaiians), Singapore (Chinese and Indians), Hong Kong, Philippines (Manila), New Caledonia (Melanesians), Alaska (American Indians), Fiji. The major risk factors are summarized, with age at first coitus as the key factor; some doubts are expressed about the validity of multiple sexual partners and circumcision of male partners as risk factors. The likely role of herpesvirus is still being studied, and the possible increase in incidence of cervical cancer among younger women could be attributed to greater sexual promiscuity in that group. Some suggestions for future research are made.

Asia, Southeastern↗