scholarly journals 973Eliminating Cervical Cancer in the Asia Pacific- From Research to Policy and Practice

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Sharon Hanley

Abstract Focus and outcomes for participants Rationale for the symposium, including for its inclusion in the Congress Cervical cancer, caused by persistent infection with oncogenic human papillomavirus (HPV), is one of the most preventable and treatable forms of cancer, yet more than 300,000 women die from the disease annually and over 500,000 cases are diagnosed. Modelling has shown that effective integration of HPV immunization programmes, HPV-based screening, and access to high-quality cancer treatment and palliative care services has the potential to eliminate cervical cancer in most countries in the world over the next century. In 2018, the Director-General of WHO made a global call to action for the elimination of cervical cancer as a public health problem. As a result, WHO has developed a global strategy towards eliminating cervical cancer as a public health problem due for endorsement at the World Health Assembly in May 2020, which proposes an elimination threshold of four cases per 100 000 women and includes 2030 triple-intervention coverage targets for scale-up of HPV vaccination of 90%, twice-lifetime cervical screening of 70%, and treatment of pre-invasive lesions and invasive cancer of 90%. As the first country to establish a national HPV immunization programme and one of the first countries to move to an HPV based screening programme, Australia has played a leading role in the global battle against cervical cancer and is on course to eliminate the disease within the next decade. However, while the burden of disease and the highest mortality from cervical cancer occur in lower income countries, factors such as the inequitable cervical cancer burden in Indigenous populations and vaccine hesitancy mean that significant barriers to the elimination of cervical cancer also exists within high-income countries. This session will have seven experts working in four countries within the Asia Pacific region. By sharing experiences and providing evidence-based guidance on key technical and strategic issues, we hope to generate a comprehensive understanding and new knowledge on factors impacting participation in, and the potential for effective scale up of, cervical cancer control programmes within the region. Presentation program Names of presenters -Dr Kate Simms is a Postdoctoral Research Fellow at Cancer Council NSW, Australia. Her research focusses on modelling the impact of HPV vaccination and cervical cancer screening across a range of settings, including predictions for the potential elimination of cervical cancer across 181 countries. -Associate Professor Julia Brotherton is a public health physician and Medical Director of VCS Population Health. She is involved in research and policy development informing the implementation and evaluation of HPV vaccination programs in Australia and is member of the WHO Director General's Expert Advisory Group on Cervical Cancer Elimination. -Assistant Professor Sharon Hanley is a cancer epidemiologist at Hokkaido University, Japan. Her research interests include HPV vaccine hesitancy and HPV self-sampling to increase cervical screening uptake in never/under screened Japanese women. - Associate Professor Lisa Whop is an Indigenous Senior Research Fellow at the Australian National University, Canberra, Australia. Her research focuses on improving health outcomes for Aboriginal and Torres Strait Islander people with cancer, with a key focus on equity. - Dr Megan Smith is a Postdoctoral Research Fellow whose research focuses on optimizing and successfully implementing cervical cancer prevention, at the population level and in different population subgroups. She has contributed to a large number of reports to government, including several evaluations that have directly informed policy in Australia, New Zealand and England. -Professor Andrew Vallely is a clinical epidemiologist at the Kirby Institute, University of New South Wales, Australia. He recently completed a field evaluation comparing point-of-care Xpert HPV testing using self-collected specimens with visual inspection of the cervix with acetic acid (VIA), to detect high-grade cervical disease. - Professor Woo Yin Ling is a Consultant Obstetrician and Gynaecologist at the University of Malaya. She is the programme designer of Project ROSE (Removal of Obstacles to Cervical Screening), a novel cervical screening research programme which employs HPV self-sampling and digital technology to increase access to cervical screening in Malaysia. Names of facilitator or chair Assistant Professor Sharon J.B. Hanley, Hokkaido University and Professor John Kaldor, Kirby Institute, University of New South Wales?

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1053 ◽  
Author(s):  
David Hawkes ◽  
Marco H. T. Keung ◽  
Yanping Huang ◽  
Tracey L. McDermott ◽  
Joanne Romano ◽  
...  

In 2018, there were an estimated 570,000 new cases of cervical cancer globally, with most of them occurring in women who either had no access to cervical screening, or had not participated in screening in regions where programs are available. Where programs are in place, a major barrier for women across many cultures has been the requirement to undergo a speculum examination. With the emergence of HPV-based primary screening, the option of self-collection (where the woman takes the sample from the vagina herself) may overcome this barrier, given that such samples when tested using a PCR-based HPV assay have similar sensitivity for the detection of cervical pre-cancers as practitioner-collected cervical specimens. Other advantages of HPV-based screening using self-collection, beyond the increase in acceptability to women, include scalability, efficiency, and high negative predictive value, allowing for long intervals between negative tests. Self-collection will be a key strategy for the successful scale up of cervical screening programs globally in response to the WHO call for all countries to work towards the elimination of cervical cancer as a public health problem. This review will examine self-collection for HPV-based cervical screening including the collection devices, assays and possible routine laboratory processes considering how they can be utilized in cervical screening programs.


2021 ◽  
Vol 39 (2) ◽  
pp. 123-131
Author(s):  
Chowdhury Shamima Sultana

HPV infection is estimated to be responsible for about 5% of human cancers worldwide. Among all HPV-associated malignancies, cervical cancer is the most important cause of morbidity and mortality worldwide. Cervical cancer is the fourth most common cancer in women worldwide and leading cause of cancer death among females in less developed countries. Persistent HPV infection is a necessary cause of invasive cervical cancer with a prevalence of 99.7% in cervical cancer worldwide.At least 70% of cervical cancers are caused by HPV 16 and HPV 18. HPV vaccination in combination with regular screening offers the most effective way for women to be protected against cervical cancer.The global burden of cervical cancer falls heaviest on the developing countries which haven’t introduced the HPV vaccine as part of their national public health strategy to prevent and control cervical cancer. Different studies showed a drop in the prevalence of HPV associated diseases in vaccinated populations. Sustained efficacy, immunogenicity, and safety of the bHPV vaccine were observed in the final analysis of a follow-up study up to 9.4 years postvaccination. Cervical cancer is a major public health problem in Bangladesh. There has been little success with screening program against cervical cancer in Bangladesh. Therefore, a National HPV Vaccination Program seems to be the window of opportunity to reduce the mortality and morbidity of cervical cancer in Bangladesh. J Bangladesh Coll Phys Surg 2021; 39(2): 123-131


Cervical neoplasia provides an overview of the 4th most common malignancy in women worldwide, including the premalignant phase. Specific terminology used in cytology and histology (including atypia, dyskaryosis, cervical intraepithelial neoplasia (CIN), cervical glandular intraepithelial neoplasia (CGIN) and invasive cervical cancer (ICC) are explained, and the epidemiology and risk factors (with an emphasis on human papilloma virus (HPV)) for this common malignancy are included. Clinical presentation is outlined. Cervical screening is discussed, including the role of HPV testing, and both the British Association for Cytopathology/NHS cervical screening program 2013 classification of cervical cytology and the Bethesda system (used more widely worldwide) are explained. Diagnosis includes colposcopic examination of the cervix, and the management of both CIN and cervical cancer are included. HPV vaccination, pregnancy, and women living with HIV (including ICC as AIDS-defining) are discussed.


2017 ◽  
Vol 11 (11) ◽  
pp. 819-825 ◽  
Author(s):  
Fatimah Saeed Alhamlan ◽  
Mohammed N A AlAhdal ◽  
Ali S Al-Zahrani ◽  
Shaihana A Almatrrouk

Cervical cancer is the fourth most common cancer affecting women, with worldwide annual incidence and mortality rates of 528,000 and 266,000, respectively, according to the World Health Organization. It is well established that cervical cancer is predominantly caused by a persistent human papillomavirus (HPV) infection of cervical cells. Increasing numbers of studies have investigated HPV and cervical cancer, contributing greatly to the global knowledge and unraveling some of the critical questions regarding HPV transmission, infection, and prevention. However, despite these studies, our knowledge is far from complete and much remains to be discovered. Although molecular detection and HPV prophylactic approaches have greatly advanced in recent years, approximately 85% of the global burden of mortality from cervical cancer still occurs in developing countries. Clinical and molecular epidemiological studies have demonstrated a need for developing countries in general to adopt cervical screening and vaccination programs. However, studies examining cervical cancer screening modalities and HPV prevalence as well as whether HPV vaccination programs should be implemented are lacking at the national level in some developing countries. Therefore, this review describes the current status of HPV in developing countries, presenting some of the existing challenges in implementing cervical screening and HPV vaccination programs.


Afrika Focus ◽  
2016 ◽  
Vol 29 (2) ◽  
Author(s):  
Heleen Vermandere

HPV vaccination prevents cervical cancer, the fourth most common cancer among women worldwide. Measured HPV vaccine acceptability is often high but does it also lead to high uptake? Methodology: A cohort was set up assessing HPV vaccine acceptability and other health behav- iour constructs before, and vaccine uptake after an HPV vaccination programme in Eldoret, Kenya. Focus groups shed light on the motivation for vaccine uptake or refusal. Results: Acceptability was high but was no strong predictor of uptake, and neither were the constructs of the Health Belief Model. Lack of information and fear of side effects were major barriers. Feeling uncomfortable to discuss cervical cancer hampered open communication. Discussion: Distrust towards new vaccines and the health system blocked translation from willingness-to-vaccinate to actual uptake, as did organizational factors such as poor promotion. Conclusion: Future research should include broader concepts such as vaccine hesitancy and factors beyond personal control in order to predict vaccine uptake. Key words: HPV vaccination, acceptability, uptake, longitudinal study, Kenya 


Author(s):  
Carla Monteiro Santos ◽  
Doralice De Almeida Nascimento Silva ◽  
Gleise Gonçalves Passos da Silva ◽  
Tatiana Santana de Oliveira ◽  
Luiz Faustino dos Santos Maia

O Câncer de Colo Uterino apresenta nos dias atuais um grande problema de saúde pública no Brasil, necessitando cada vez mais de profissionais capacitados para o combate a essa doença maligna, minimizando sua morbimortalidade. Neste âmbito podemos destacar o Papel do enfermeiro como fundamental na transformação dessa realidade que vivemos hoje. O enfermeiro atua tanto no sentido de assistir, coordenar as práticas de cuidado, quanto no sentido de educar, promover, proteger, reabilitar essas mulheres, de forma autônoma, criativa e ativa nos múltiplos níveis de atenção à saúde, através do levantamento de hipóteses analíticas e intervenções sistematizadas de rotinas de cuidados, subsidiando falhas e promovendo continuidade e resolutividade do cuidado em saúde.Descritores: Câncer de Colo Uterino, Mulher, Enfermagem. Nurses in care woman with cervical cancerAbstract: The Cancer Cervical presents nowadays a major public health problem in Brazil, requiring more and more trained professionals to combat this evil disease, minimizing morbidity and mortality. In this context we can highlight the nurse's role as fundamental in transforming this reality we live in today. The nurse acts both to assist coordinate care practices, as to educate, promote, protect, rehabilitate these women in an autonomous, creative and active in multiple health care levels, through the lifting of analytical assumptions systematized and interventions care routines, subsidizing failure and promoting continuity and resolution of health care. Descriptors: Cervical Cancer, Women, Nursing. Enfermero en la atención la mujer con cáncer de cuello uterinoResumen: Los regalos del cáncer de cuello uterino hoy en día un importante problema de salud pública en Brasil, lo que requiere cada vez más capacitados profesionales para combatir esta enfermedad mal, lo que minimiza la morbilidad y la mortalidad. En este contexto cabe destacar el papel de la enfermera tan fundamental en la transformación de esta realidad que vivimos hoy. La enfermera actúa tanto para ayudar, coordinar las prácticas de atención, como para educar, promover, proteger, rehabilitar a estas mujeres en un autónomas, creativas y activas en múltiples niveles de atención de salud, a través de la elevación de supuestos analíticos rutinas sistematizados y las intervenciones de atención, subsidiando el fracaso y la promoción de la continuidad y de la resolución de la atención sanitaria. Descriptores: Cáncer de Cuello Uterino, Mujer, Enfermería.


2020 ◽  
Vol 14 (12) ◽  
pp. e0008943
Author(s):  
Shelui Collinson ◽  
Joseph Timothy ◽  
Samuel K. Zayzay ◽  
Karsor K. Kollie ◽  
Eglantine Lebas ◽  
...  

Scabies is known to be a public health problem in many settings but the majority of recent data is from rural settings in the Pacific. There is a need for high quality data from sub-Saharan Africa and peri-urban settings to inform scale up of scabies control efforts. There have been anecdotal reports of scabies being a public health problem in Liberia but robust data are lacking. We conducted a cross-sectional cluster-randomised prevalence survey for scabies in a peri-urban community in Monrovia, Liberia in February-March 2020. Participants underwent a standardised examination conducted by trained local health care workers. Health related quality of life (HRQoL) was assessed using age-appropriate versions of the dermatology life quality index (DLQI). Prevalence estimates were calculated accounting for clustering at community and household levels and associations with key demographic variables assessed through multivariable random-effects logistic regression. 1,318 participants from 477 households were surveyed. The prevalence of scabies was 9.3% (95% CI: 6.5–13.2%), across 75 (19.7%) households; impetigo or infected scabies prevalence was 0.8% (95% CI: 0.4–1.9%). The majority (52%) of scabies cases were classified as severe. Scabies prevalence was lower in females and higher in the youngest age group; no associations were found with other collected demographic or socio-economic variables. DLQI scores indicated a very or extremely large effect on HRQoL in 29% of adults and 18% of children diagnosed with scabies. Our study indicates a substantial burden of scabies in this peri-urban population in Liberia. This was associated with significant impact on quality of life, highlighting the need for action to control scabies in this population. Further work is needed to assess the impact of interventions in this context on both the prevalence of scabies and quality of life.


Tequio ◽  
2018 ◽  
Vol 2 (4) ◽  
pp. 15-25
Author(s):  
Édgar Villegas Hinojosa ◽  
Verónica Gallegos García ◽  
Anahid Elizabeth Campuzano Barajas ◽  
Omar Medina de la Cruz ◽  
Luz Eugenia Alcántara Quintana

Cervical cancer (CeCa) is a public health problem, the prevention efforts have focused on the screening of women at risk of contracting the disease since timely prevention can predict the evolution of the disease. The purpose of the histopathological study is to provide a more accurate diagnosis in order to give guidelines on the basis of which the treatment and follow-up of the patients is planned. However, despite the certainty of the histopathological study, certain methodological improvements have been suggested in which some researches report that making cuts at different levels in the paraffin block of the cervical biopsy could increase the sensitivity of the histopathological study.


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