Logistic Regression for the Diagnosis of Cervical Cancer

2019 ◽  
pp. 109-117
Author(s):  
Siddharth Singh ◽  
Shweta Panday ◽  
Manjusha Panday ◽  
Siddharth S. Rautaray
Keyword(s):  
Cervical Cancer ◽  
Logistic Regression

scholarly journals GJA1 Expression and Its Prognostic Value in Cervical Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Silu Meng ◽  
Xinran Fan ◽  
Jianwei Zhang ◽  
Ran An ◽  
Shuang Li
Keyword(s):  
Gene Expression ◽  
Cervical Cancer ◽  
Logistic Regression ◽  
Gap Junction ◽  
Signaling Pathway ◽  
Immune Cells ◽  
Immune Cell ◽  
Normal Tissues ◽  
Kaplan Meier ◽  
Chi Squared

Gap Junction Protein Alpha 1 (GJA1) belongs to the gap junction family and has been widely studied in cancers. We evaluated the role of GJA1 in cervical cancer (CC) using public data from The Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) database. The difference of GJA1 expression level between CC and normal tissues was analyzed by the Gene Expression Profiling Interactive Analysis (GEPIA), six GEO datasets, and the Human Protein Atlas (HPA). The relationship between clinicopathological features and GJA1 expression was analyzed by the chi-squared test and the logistic regression. Kaplan–Meier survival analysis and Cox proportional hazard regression analysis were used to assessing the effect of GJA1 expression on survival. Gene set enrichment analysis (GSEA) was used to screen the signaling pathways regulated by GJA1. Immune Cell Abundance Identifier (ImmuCellAI) was chosen to analyze the immune cells affected by GJA1. The expression of GJA1 in CC was significantly lower than that in normal tissues based on the GEPIA, GEO datasets, and HPA. Both the chi-squared test and the logistic regression showed that high-GJA1 expression was significantly correlated with keratinization, hormone use, tumor size, and FIGO stage. The Kaplan–Meier curves suggested that high-GJA1 expression could indicate poor prognosis ( p = 0.0058 ). Multivariate analysis showed that high-GJA1 expression was an independent predictor of poor overall survival (HR, 4.084; 95% CI, 1.354-12.320; p = 0.013 ). GSEA showed many cancer-related pathways, such as the p53 signaling pathway and the Wnt signaling pathway, were enriched in the high-GJA1-expression group. Immune cell abundance analysis revealed that the abundance of CD8 naive, DC, and neutrophil was significantly increased in the high-GJA1-expression group. In conclusion, GJA1 can be regarded as a potential prognostic marker of poor survival and therapeutic target in CC. Moreover, many cancer-related pathways may be the critical pathways regulated by GJA1. Furthermore, GJA1 can affect the abundance of immune cells.

Rising Rates of Upfront Surgery in Early Locally Advanced Cervical Cancer: What Factors Predict for This Treatment Paradigm?

2018 ◽  
Vol 28 (8) ◽  
pp. 1560-1568 ◽  
Author(s):  
Arya Amini ◽  
Tyler P. Robin ◽  
Priscilla K. Stumpf ◽  
Chad Rusthoven ◽  
Tracey E. Schefter ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Logistic Regression ◽  
Locally Advanced ◽  
Median Income ◽  
Advanced Cervical Cancer ◽  
Postoperative Radiation Therapy ◽  
Locally Advanced Cervical Cancer ◽  
Gynecology And Obstetrics ◽  
Treatment Paradigm ◽  
Care Costs

ObjectiveIn this study, we analyzed patterns of care for patients with locally advanced cervical cancer to identify predictors for upfront surgery compared with definitive chemoradiation (CRT).MethodsThe National Cancer Database was queried for patients aged 18 years or older with Federation of Gynecology and Obstetrics IB2–IIB cervical cancer. All patients underwent either upfront hysterectomy with or without postoperative radiation therapy versus definitive CRT. Logistic regression was used to assess variables associated with modality of treatment (surgery vs CRT).ResultsOf the 9494 patients included, 2151 (22.7%) underwent upfront surgery. Of those undergoing surgery, 380 (17.7%) had positive margins, 478 (22.2%) had positive nodes, and 458 (21.3%) had pathologic involvement of the parametrium. Under multiple logistic regression, rates of surgery significantly increased from 2004 (12.2%) to 2012 (31.2%) (odds ratio [OR] per year increase, 1.15; confidence interval [CI], 1.12–1.17; P < 0.001). Upfront surgery was more commonly performed in urban (OR, 1.21; 95% CI, 1.03–1.41; P = 0.018) and rural counties (OR, 1.79; 95% CI, 1.24–2.58; P = 0.002), for adenocarcinoma (OR, 2.14; 1.88–2.44; P < 0.001) and adenosquamous (OR, 2.69; 2.11–3.43; P < 0.001) histologies, and in patients from higher median income communities (ORs, 1.19–1.37). Upfront surgery was less common at academic centers (OR, 0.73; 95% CI, 0.58–0.93; P = 0.011).ConclusionsRates of upfront surgery relative to definitive CRT have increased significantly over the past decade. In the setting of level 1 evidence supporting the use of definitive CRT alone for these women, the rising rates of upfront surgery raises concern for both unnecessary surgical procedures with higher rates of treatment-related morbidity and greater health care costs.

HIV associated cancers.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18254-e18254
Author(s):  
Prabhjot Singh Bedi ◽  
Manoj P. Rai ◽  
Fawzi Abu Rous ◽  
Rohanlal Vishwanth ◽  
Nishraj Basnet ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Logistic Regression ◽  
Head And Neck Cancer ◽  
Skin Cancer ◽  
Head And Neck ◽  
Hodgkin Lymphoma ◽  
Anal Cancer ◽  
Kaposi Sarcoma ◽  
P Value ◽  
Non Hodgkin Lymphoma

e18254 Background: The incidence or the prevalence of AIDS-defining cancers has reduced drastically (70% or more in the United States) since the introduction of three-drug antiretroviral therapy (ART) in the mid-1990s. However, the data from the inpatient sample is lacking. Methods: This is a retrospective analysis using data from the 2014 National Inpatient Sample database. We identified patients with either primary or secondary diagnosis of human immunodeficiency virus (HIV). Then we identified patients with various cancers including AIDS-defining cancers. Afterward, we ran logistic regression to check the degree of association between the diagnosis of each cancer with the diagnosis of HIV during the identified hospitalizations. We also assessed the prevalence of each of the cancer among the identified HIV patients, as well as the mortality in this cohort. Results: A total of 115955 hospitalizations with a diagnosis of HIV were identified. Among them, there were 6985 hospitalizations with Non-Hodgkin lymphoma, 2230 with rectal and anal cancer, 1170 with Kaposi sarcoma, 870 with head and neck cancer, 865 with skin cancer, 840 with cervical cancer. Logistic regression showed odds ratio (OR) of 1632.857 (95% CI 1168 - 2284, p < 0.01) for Kaposi sarcoma, 9.13 (95% CI 5.7-14.5, p-value < 0.01) for other male cancer, 8.34 (95% CI 7.68-9.06; p-value < 0.01) for Non-Hodgkin's lymphoma, 6.65 (95% CI was 5.5-8, p-value < 0.01) for Hodgkin's lymphoma, 5.04 (95% CI 4.5-5.6 p < 0.01) for rectal and anal cancer, 2.33 (95% CI 1.9-2.8, p < 0.01) for cervical cancer. Mortality was statistically significant with liver cancer, lung cancer, brain cancer, Hodgkin lymphoma, and Kaposi sarcoma. Conclusions: The prevalence of Kaposi sarcoma, Non-Hodgkin lymphoma, and cervical cancer are found to be high among hospitalized patients with HIV most likely because of nonadherence to their HIV medications. Future studies to check their correlation of these cancers with disease control is required. It is interesting to note that the prevalence of rectal and anal cancer, head and neck cancer, and skin cancer is high in this cohort.

scholarly journals Some Traits on the Outcome of the Treatment of Cervical Cancer in Tanzania: A Case Study of Ocean Road Cancer Institute (ORCI)

2020 ◽  
Vol 21 (2) ◽  
pp. 1-9
Author(s):  
Bakari L Leguma ◽  
Rajabu Rocky Akarro ◽  
Amina Suleiman Msengwa ◽  
Francis Joseph Sichona
Keyword(s):  
Cervical Cancer ◽  
Logistic Regression ◽  
Cancer Patients ◽  
Odds Ratio ◽  
Disease Stage ◽  
Hiv Status ◽  
African Countries ◽  
Chi Square ◽  
Early Stages ◽  
Treatment Type

Background: In Tanzania, like in many other poor African countries, cervical cancer is a major problem facing women especially for those aged 30 years and above. This study aimed at constructing a statistical model to enable the prediction of the outcome of treatment for cervical cancer patients in Tanzania. Methods: Data were collected retrospectively from patient’s files with histological proven cervical cancer who were treated at Ocean Road Cancer Institute (ORCI) from year 2009 and followed up to year 2011. The factors considered are screening status, HIV status, disease stage, age, treatment type and the intent of the treatment. The study employed the Chi-square (χ2) test and the logistic regression model for its analysis. Results:  The Chi-square (χ2) test result showed that there was a significant relationship between outcome of treatment and the patient screening status, HIV status, disease stage and intent of treatment at 5% level of significance. On the other hand, the logistic regression results found patient disease stage and intent of the treatment to be statistically significant at 95 percent. Logistic regression results also showed that patients who attended ORCI when their disease at a late stage had an odds ratio of 0.128 less likely to have favorable outcomes compared to those patients who attended ORCI when their disease stage was at early stages. The odds ratio for cervical cancer patients who received both treatment, radiotherapy, and chemotherapy was 2.643 more likely to have favorable outcomes Conclusion:  More emphasis and campaigns should be made in order to encourage women all over the country to attend cancer centers for screening and treatment at early stages or even before any symptoms for cervical cancer and other types of cancers.

scholarly journals Cervical Cancer Screening Uptake and Determinant Factors Among Women in Ambo Town, Western Oromia, Ethiopia: Community based Cross Sectional Study

2021 ◽  
Author(s):  
Shewaye Fituma Natae ◽  
Digafe Tsegaye Nigatu ◽  
Mulu Kitaba Negawo ◽  
Wakeshe Willi Mengesha
Keyword(s):  
Cervical Cancer ◽  
Logistic Regression ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Screening Service ◽  
Community Based ◽  
Cross Sectional ◽  
Screening Uptake

Abstract Background: Cervical cancer is one of the principal causes of cancer death among women worldwide. It is the second most common cancer and the leading cause of cancer-related death in Ethiopian women; about 77.6% of women died of 6,294 new cases reported in 2019. Early screening for cervical cancer has substantial advantage to reduce the incidence, morbidity, and mortality attributed to cervical cancer. So far, there are limited evidence on the level of cervical cancer screening uptake and its determinant in low- and middle-income countries including Ethiopia. Consequently, the current study aimed to assess the level of cervical cancer screening uptake and its determinant among women of Ambo town, western Oromia, Ethiopia.Methods: A community-based cross-sectional study was conducted among 422 women aged 20-65years. Systematic random sampling was employed to recruit the eligible women from randomly selected sub-districts found in Ambo town. Interviewer-administered questionnaire was used to collect the data. Epi info was used for data entry and management from which it was exported to SPSS version 25 for detailed analysis. Variables in binary logistic regression with a p-value <0.25 were candidate for multivariable logistic regression. Estimates were presented using odds ratios (ORs) with 95% CI. Statistical Significance was declared at p value<0.05.Results: In the present study 392 women were participated giving a response rate of 93%. Overall, 63% of the respondents were known the availability of cervical cancer screening service. Only 8.7% (34) of the study participants were received cervical cancer screening in their lifetime. Being in the age group of 30-39 years (AOR=3.2; 95% CI [1.22, 8.36]) and 40-49years (AOR=4.8; 95% CI [1.42, 16.41]), having cervical cancer related discussion with health care provider (AOR=3.5; 95% CI [1.17, 10.7]), and knowing availability cervical cancer screening service (AOR=2.8; 95% CI [1.03, 7.87]) were significantly associated with uptake of cervical cancer screening. Conclusion: In this study, cervical cancer screening uptake is very low. The study also highlighted important factors that affect uptake of cervical cancer screening service. Therefore, this study result call urgent interventions by all stockholders to increase cervical cancer service uptake through continues promotions and by securing its availability and accessibility for all eligible women at all levels.

scholarly journals Clinical Outcomes Observation in Stage IIB–III Cervical Cancer Treated by Adjuvant Surgery Following Concurrent Chemoradiotherapy

2020 ◽  
Author(s):  
Yong Li ◽  
Zhiying Chen ◽  
Xiang Wang ◽  
Xiumei Li ◽  
Jie Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Logistic Regression ◽  
Operation Time ◽  
Residual Tumor ◽  
Postoperative Recurrence ◽  
Surgery Complications ◽  
Combined Surgery ◽  
Adjuvant Surgery ◽  
Completion Surgery

Abstract Objective: To explore the feasibility of adjuvant surgery following concurrent chemoradiation therapy (CCRT) in stage ⅡB–Ⅲ cervical cancer. And analyze risk factors of recurrence after surgery. Methods: Forty-nine patients diagnosed with stage ⅡB–Ⅲ cervical cancer were reviewed retrospectively. Investigated the risk factors of recurrence after surgery using Chi-squared Test and further analyzed multiple factors affecting postoperative recurrence using the multi-factor logistic regression. Furthermore, the correlation of surgery outcomes (including operation time, bleeding, and hospitalization date and surgery complications) with the time which carried out between CCRT and completion surgery was analyzed. Results: Tumor histology and residual tumor in the cervix were significantly associated with postoperative recurrence (P = 0.014 and P = 0.040, respectively). Logistic regression analysis demonstrated that the independent risk factors of postoperative recurrence were age and residual tumor in the cervix (P = 0.017 and P = 0.030, respectively). Compared with completion surgery was carried out ≤ 6 weeks after CCRT, the operation time, bleeding, hospitalization date and surgery complications were more than > 6 weeks group. Moreover, bleeding and surgery complications were statistically significant (P = 0.019 and P = 0.044, respectively). Conclusion: CCRT combined surgery for stage ⅡB–Ⅲ cervical cancer was feasible, reduced the rate of postoperative recurrence and surgery complications were tolerated. CCRT combined surgery might improve the local control of lesion.

scholarly journals Mitochondrial DNA copy number in cervical exfoliated cells and risk of cervical cancer among HPV-positive women

2019 ◽  
Author(s):  
Wei Sun ◽  
Xueyun Qin ◽  
Jing Zhou ◽  
Mingjing Xu ◽  
Zhangyan Lyu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Logistic Regression ◽  
Mitochondrial Dna ◽  
Copy Number ◽  
Wald Test ◽  
Hpv Infection ◽  
Dna Copy Number ◽  
Mitochondrial Dna Copy Number ◽  
Exfoliated Cells ◽  
Hpv Types

Abstract Background Although human papillomavirus (HPV) infection has been recognized as the major cause of cervical cancer, only a minority of HPV-infected women develop this malignancy. An increasing amount of evidence suggests that alterations of mitochondrial DNA copy number (mtCN) may c ontribute to carcinogenesis. However, the relationship between mtCN and cervical cancer remains unknown. Methods In this case-control study, we included 591 cervical cancer cases and 373 cancer-free controls, all of whom were infected with high-risk HPV. Relative mtCN in cervical cancer exfoliated cells was measured by qRT-PCR assay s , and logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Interaction between mtCN and HPV types was assessed by using the Wald test in logistic regression models. Results HPV16, 18, 52, and 58 were the most common types in both case and control groups. Median mtCN in cases was significantly higher than that in controls ( P = 0.03). After adjustment for age and HPV types , the highest quartile of mtCN was associated with increased odds of having cervical cancer (OR = 1.77, 95% CI = 1.19, 2.62; P < 0.01), as compared to the lowest quartile. A dose-response effect of mtCN on cervical cancer was also observed ( P trend < 0.001). The interaction between mtCN and HPV types was statistically nonsignificant. Conclusions Increased mtCN in cervical exfoliated cells is associated with cervical cancer after HPV infection, suggesting a potential role of mtCN in cervical carcinogenesis.

scholarly journals Knowledge of cervical cancer screening and associated factors among women attending maternal health services at Aira Hospital, West Wollega, Ethiopia

2021 ◽  
Vol 9 ◽  
pp. 205031212110470
Author(s):  
Megersa Argaw Aredo ◽  
Endalew Gemechu Sendo ◽  
Jembere Tesfaye Deressa
Keyword(s):  
Cervical Cancer ◽  
Logistic Regression ◽  
Cancer Screening ◽  
Maternal Health ◽  
Health Services ◽  
Cervical Cancer Screening ◽  
Associated Factors ◽  
Maternal Health Services ◽  
Outcome Variable ◽  
Monthly Income

Background: Cervical cancer is one of the major noncommunicable public health problems among women globally. About 500,000 women develop cervical cancer each year, with an estimated 85% or more occurring in developing countries, including Ethiopia. Objective: The main objective of the study was to assess the knowledge of cervical cancer screening and its associated factors among women attending maternal health services at Aira hospital, West Wollega, Ethiopia. Methods: An institutional-based cross-sectional study design was conducted among 421 reproductive-age women. A systematic sampling method was used for the study. Data were collected using a pretested and structured questionnaire. Data analysis included descriptive statistics and the statistical association between the outcome variable and the explanatory variables tested by the binary logistic regression. Multivariable logistic regression was used to control confounding factors, the magnitude of the association between the different independent and dependent variable was measured using 95% confidence interval, and p values below 0.05 were considered as statistically significant. Results: A total of 421 women were responded with 100% response rate and with the mean age of 26.0 ± 5.15 (M ± SD) years. About 95.0% of the respondents ever heard of cervical cancer and 46.8% of the respondents had good knowledge about cervical cancer screening. Age, occupation, educational level, and monthly income were predictors associated with knowledge about cervical cancer screening. Conclusion: The study revealed 46.8% of study participants had knowledge about cervical cancer screening. The age of the participant, occupation, level of education, and monthly income were determinants of knowledge about cervical cancer screening. Prevention programs should focus on cervical cancer screening according to identified factors in the study.

scholarly journals Clinical Outcomes Observation in Stage IIB–III Cervical Cancer Treated by Adjuvant Surgery Following Concurrent Chemoradiotherapy

2020 ◽  
Author(s):  
Yong Li ◽  
Zhiying Chen ◽  
Xiang Wang ◽  
Xiumei Li ◽  
Jie Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Logistic Regression ◽  
Operation Time ◽  
Residual Tumor ◽  
Postoperative Recurrence ◽  
Surgery Complications ◽  
Combined Surgery ◽  
Adjuvant Surgery ◽  
Completion Surgery

Abstract Objective: To explore the feasibility of adjuvant surgery following concurrent chemoradiation therapy (CCRT) in stage ⅡB–Ⅲ cervical cancer. And analyze risk factors of recurrence after surgery. Methods: Forty-nine patients diagnosed with stage ⅡB–Ⅲ cervical cancer were reviewed retrospectively. Investigated the risk factors of recurrence after surgery using Chi-squared Test and further analyzed multiple factors affecting postoperative recurrence using the multi-factor logistic regression. Furthermore, the correlation of surgery outcomes (including operation time, bleeding, and hospitalization date and surgery complications) with the time which carried out between CCRT and completion surgery was analyzed. Results: Tumor histology and residual tumor in the cervix were significantly associated with postoperative recurrence (P = 0.014 and P = 0.040, respectively). Logistic regression analysis demonstrated that the independent risk factors of postoperative recurrence were age and residual tumor in the cervix (P = 0.017 and P = 0.030, respectively). Compared with completion surgery was carried out ≤ 6 weeks after CCRT, the operation time, bleeding, hospitalization date and surgery complications were more than > 6 weeks group. Moreover, bleeding and surgery complications were statistically significant (P = 0.019 and P = 0.044, respectively).Conclusion: CCRT combined surgery for stage ⅡB–Ⅲ cervical cancer was feasible, reduced the rate of postoperative recurrence and surgery complications were tolerated. CCRT combined surgery might improve the local control of lesion.

scholarly journals The Women Who Fear the Unknown: Potential Drivers of the Cervical Cancer Epidemic in Rural Nigeria

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 27s-27s
Author(s):  
O. Abiodun ◽  
O. Olu-Abiodun
Keyword(s):  
Cervical Cancer ◽  
Logistic Regression ◽  
Local Government ◽  
Cervical Screening ◽  
Outcome Variable ◽  
Sexually Active ◽  
Multivariate Logistic Regression ◽  
Community Based ◽  
Rural Nigeria ◽  
Screening Result

Background: Visual inspection of the cervix under acetic acid is the most cost-effective method for the control of cervical cancer in sub-Saharan Africa. The region bears about 90% of the global burden of the disease accounting for about 85% of new disease and more than 90% of the mortality. The WHO piloted a largely successful community-based cervical screening in six African countries including Nigeria between 2009 and 2012. Community-based cervical screening was subsequently adopted in Nigeria as a major strategy for preventing cervical cancer. An evaluation of the community-based cervical screening in two rural local government areas in Ogun state, Nigeria, however, revealed that more than 95% of sexually active women had never had cervical screening done despite availability of the services. A substantial number of these women would not want to have cervical screening done because of the fear of a positive cervical screening result. Aim: The current study explored the characteristics of women who are unwilling to have cervical screening because of the fear of a negative result in two rural local government areas in Nigeria. Methods: A post hoc analysis of data collected for the evaluation of community-based cervical screening in two rural LGAs in Nigeria. The analysis described the characteristics of 700 sexually active women aged 25 to 64 years who declined to have cervical screening. The socio-demographic characteristics, perception (0 to 6) and knowledge scores (0 to 36) of the participants were fitted into a multivariate logistic regression model to predict the fear of an unfavorable cervical screening result. Results: About 81% (567) of the women were unwilling to get a cervical screening due to the fear of a negative result. Age, gravidity, knowledge, and perception about cervical cancer and screening were associated with the women declining cervical screening due to the fear of a negative result. On multivariate logistic regression analysis age (OR: 0.968, P = 0.007) and knowledge score (OR: 0.914, P < 0.001) were found to predict the fear of a negative result. The adjusted outcome variable model showed fair discrimination (AUC = 0.67) and good calibration ( P = 0.416). Conclusion: Many women in rural Nigeria decline to have cervical screening mainly because of the fear of a negative result which is in turn predicted by younger age and poorer knowledge scores about cervical cancer and screening. There is a need for further qualitative research to explore the dimensions of fear as it relates to refusal to have cervical screening among rural women in Nigeria.

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