Prevalence of human papillomavirus infection, cervical intraepithelial neoplasia and cervical cancer in imprisoned women worldwide: a systematic review and meta-analysis

2019 ◽  
Vol 74 (1) ◽  
pp. 95-102 ◽  
Author(s):  
Nadia Escobar ◽  
Emma Plugge
Keyword(s):  
Cervical Cancer ◽  
General Population ◽  
Cervical Intraepithelial Neoplasia ◽  
Precancerous Lesions ◽  
Cervical Screening ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Current Evidence ◽  
Significant Heterogeneity ◽  
Prevalence Estimates

Background and objectivesImprisoned women have higher rates of abnormalities at cervical screening and some studies suggest that cervical cancer is the most common cancer in this population. The aim of this work was to summarise the current evidence on the prevalence of human papilloma virus (HPV) infection, cervical cancer and precancerous lesions in women in prison worldwide and to compare these rates with the general population.MethodsWe systematically searched and reviewed published and unpublished data reporting the prevalence of any HPV infection, cervical intraepithelial neoplasia (CIN) and cervical cancer in imprisoned women. We created forest plots with prevalence estimates from studies with comparable outcomes and of prevalence ratios using data from national screening programmes as a comparison group.FindingsA total of 53 533 imprisoned women from 10 countries and 35 studies were included in the review. The prevalence of HPV among prisoners ranged from 10.5% to 55.4% with significant heterogeneity. The prevalence of CIN diagnosed by cytology in prisoners ranged from 0% to 22%. Ratios comparing the prevalence of CIN in imprisoned women to that in the community ranged from 1.13 to 5.46. Cancer prevalence estimates were at least 100 times higher than in populations participating in national screening programmes.ConclusionImprisoned women are at higher risk of cervical cancer than the general population. There is a high prevalence of HPV infection and precancerous lesions in this population. Targeted programmes for control of risk factors and the development of more effective cervical screening programmes are recommended.PROSPERO registration numberCRD42014009690.

scholarly journals Photodynamic Therapy for Low-grade Cervical Intraepithelial Neoplasia (CIN1): A Case Report

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Yinyin Zhang ◽  
Hong Lin ◽  
Huizhen Fan
Keyword(s):  
Photodynamic Therapy ◽  
Cervical Intraepithelial Neoplasia ◽  
Persistent Infection ◽  
Precancerous Lesions ◽  
Irradiation Time ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Cervical Canal ◽  
Low Grade ◽  
Oxygen Inhalation

As a drug-mechanical combination technology, photodynamic (PDT) can achieve accurate and targeted therapy for malignant tumors and benign diseases through the production of reactive oxygen species, oxygen free radicals or singlet oxygen by photosensitizers at specific wavelengths. Compared with traditional surgery, it has the advantages of selective killing, repeatable treatment, preserving target organ function and so on. The purpose of this study was to explore the clinical value of photodynamic therapy in cervical precancerous lesions by taking the patients with low-grade cervical intraepithelial neoplasia (CIN1) with high-risk human papillomavirus (HR-HPV) persistent infection diagnosed by "three-step diagnosis and treatment procedure" as an example. Using HiPorfin as a photosensitizer, photodynamic therapy was performed 48 hours after intravenous drip. Set laser wavelength 630nm, light dose density 137.58J/cm2, transmission efficiency 1.42, output power 2w. 3cm columnar optical fiber was placed around the 2cm in the cervical canal to cover all the lesions, and the irradiation time was 900s (600s in the cervical canal and 300s outside the cervical canal). The patients were given oxygen inhalation for 6 hours after operation, and the patients were observed for itching and other discomfort, and paid attention to avoid light. Photodynamic therapy was performed again in the same way on the second day. After two months of treatment, pathological biopsy showed chronic cervicitis, indicating that the disease had been effectively controlled. Theoretically, although the patient is not the absolute indication of photodynamic therapy (that is, meeting CIN ? or CIN ?, having fertility requirements and not undergoing surgery), this therapy can remove not only the superficial lesions inside and outside the cervix, but also the potential lesions not found under colposcopy. It can also block the persistent infection of HPV by inhibiting the expression of HPV18, E6 and E7mRNA in Hela cells. In combination with Baofukang suppository, it can block HPV infection. Increase the negative conversion rate of cervical HPV and reduce the probability of recurrence after CIN1 cure. For young female patients with persistent HR-HPV infection and fertility requirements, photodynamic therapy is an effective choice for clinical treatment of CIN1.

scholarly journals Human papillomavirus genotype distribution in cervical intraepithelial neoplasia 2/3 and invasive cervical cancer among Hakka women in southern China

2019 ◽  
Author(s):  
Xiaodong Gu ◽  
Ruiqiang Weng ◽  
Jing Liu ◽  
Sudong Liu
Keyword(s):  
Cervical Cancer ◽  
Cervical Intraepithelial Neoplasia ◽  
Southern China ◽  
Invasive Cervical Cancer ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Histological Diagnosis ◽  
Infection Prevalence ◽  
Genotype Distribution ◽  
Hpv Genotypes

Abstract Background: To investigate HPV genotype distribution in cervical intraepithelial neoplasia 2/3 (CIN2/3) and invasive cervical cancer (ICC) among Hakka women in southern China. Methods: Results of HPV genotypes from women with histological diagnosis of CIN2/3 and ICC were collected from January, 2017 to December, 2018. HPV genotypes were analyzed by flow cytometry method. Association of HPV infection and lesions severity was estimated using prevalence ratio (PR). Results: Overall, 1,408 Hakka women with histological diagnosis of CIN2/3 and ICC were enrolled in this study. HPV infection prevalence was 92.92% in CIN2, 95.77% in CIN3 and 95.88% in ICC. Most frequent genotypes for CIN2 were HPV52 (31.42%), HPV16 (22.12%) and HPV58 (22.12%); for CIN3 were HPV16 (41.90%), HPV52 (20.77%) and HPV58 (18.31%); and for ICC were HPV16 (49.67%), HPV18 (11.25%) and HPV52 (9.80%). PR of HPV16 and HPV33 were significantly higher in CIN3 compared with CIN2 (PR = 2.372, 95%CI = 1.598-3.524; PR = 2.577, 95%CI = 1.250-5.310; respectively). HPV16 and HPV18 prevalence were significantly increasing in SCC compared with CIN3 (PR = 2.517, 95%CI = 1.095-5.786; PR = 2.473, 95%CI = 1.840-3.324; respectively). Most HPV infections were found in women aged 40 – 49 years in CIN2/3 and women aged 50 - 59 years in ICC. Conclusions: This is the first study of genotypes and age specific distribution of HPV infection among Hakka women with CIN2/3 and ICC in southern China. Our results provide available information for HPV vaccine development in China.

scholarly journals Comprehensive genomic variation profiling of cervical intraepithelial neoplasia and cervical cancer identifies potential targets for cervical cancer early warning

2018 ◽  
Vol 56 (3) ◽  
pp. 186-194 ◽  
Author(s):  
Jian Huang ◽  
Zhaoyang Qian ◽  
Yuhua Gong ◽  
Yanzhou Wang ◽  
Yanfang Guan ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Molecular Mechanisms ◽  
Mutational Analysis ◽  
Deep Understanding ◽  
Genomic Analysis ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Genomic Variation

BackgroundTo better understand the pathogenesis of cervical cancer (CC), we systematically analysed the genomic variation and human papillomavirus (HPV) integration profiles of cervical intraepithelial neoplasia (CIN) and CC.MethodsWe performed whole-genome sequencing or whole-exome sequencing of 102 tumour-normal pairs and human papillomavirus probe capture sequencing of 45 CCs, 44 CIN samples and 25 normal cervical samples, and constructed strict integrated workflow of genomic analysis.ResultsMutational analysis identified eight significantly mutated genes in CC including four genes (FAT1, MLL3, MLL2 and FADD), which have not previously been reported in CC. Targetable alterations were identified in 55.9% of patients. In addition, HPV integration breakpoints occurred in 97.8% of the CC samples, 70.5% of the CIN samples and 42.8% of the normal cervical samples with HPV infection. Integrations of high-risk HPV strains in CCs, including HPV16, 18, 33 and 58, also occurred in the CIN samples. Moreover, gene mutations were detected in 52% of the CIN specimens, and 54.8% of these mutations occurred in genes that also mutated in CCs.ConclusionOur results lay the foundation for a deep understanding of the molecular mechanisms and finding new diagnostic and therapeutic targets of CC.

scholarly journals EXPERIENCE OF IMMUNOCORRECTIVE TREATMENT IN THE MANAGEMENT OF PATIENTS WITH CERVICAL INTRAEPITHELIAL NEOPLASIA ON THE BACKGROUND OF GENITAL PAPILLOMAVIRUS INFECTION

2021 ◽  
pp. 48-53
Author(s):  
N. M. ROZHKOVSKA ◽  
I. Z. GLADCHUK ◽  
N. M. KASHTALYAN ◽  
Ia. V. ROZHKOVSKYI
Keyword(s):  
Cervical Cancer ◽  
Cervical Intraepithelial Neoplasia ◽  
Cold Plasma ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Immunomodulatory Therapy ◽  
Complex Treatment ◽  
Papillomavirus Infection ◽  
Plasma Ablation ◽  
Interferon Status

Introduction. Human papillomavirus (HPV), its highly oncogenic types, is considered to be the initiating factor in the development of dysplasia and cervical cancer The role of immunomodulatory therapy in reducing the risk of cervical cancer in women with cervical intraepithelial neoplasia (CIN) associated with HPV infection remains in the focus of researchers. Aim of the study: to evaluate the effectiveness of the use of the immunomodulator Allokin-alfa in the complex treatment of cervical intraepithelial neoplasia against the background of genital papillomavirus infection. Materials and methods. We examined 60 women who received CIN1- 2 treatment on the background of HPV infection of high oncogenic risk in the multidisciplinary medical center of the Odessa National Medical University. The patients were divided into 2 groups: 1 (main) group consisted of 30 women who received cold plasma ablation of cervical dysplasia in combination with immunomodulatory therapy with alloferon, group 2 (comparison) consisted of 30 patients who received standard cold plasma ablative treatment without immunomodulators. The control group consisted of 30 healthy women. All women underwent cytomorphological examination of the cervical epithelium, HPV testing, colposcopy, and targeted biopsy. Immunological status was assessed by indicators of cellular and humoral immunity, the content of α- and γ-interferon. Results. In patients with CIN1-2 against the background of HPV, an increase in the level of serum Ig A, CD8 level, a decrease in the CD4 content and immunoregulatory index, CD19 content were revealed, which indicated immunosuppression. Immunocorrective therapy witn alloferon (Allokin-alfa) in complex, with cold plasma ablation, treatment of CIN1-2 promoted the normalization of the parameters of immunity and interferon status, which contributed to the acceleration of epithelialization, (OR — 15,48; 95% CІ: 2,05-136,45; р=0,0094). a decrease in the frequency of residual lesions, and a HPV elimination. Conclusions. Complex treatment of CIN1-2 using cold plasma ablation and immunocorrection by perioperative administration of alloferon (Allokin-alfa) is accompanied by better functional results, compared only with the use of cold plasma ablation: accelerated epithelialization, improved colposcopic picture, decreased frequency of relapses, elimination of HPV, normalization of immunе and interferon status.

scholarly journals Primary cervical screening with high risk human papillomavirus testing: observational study

BMJ ◽  
2019 ◽  
pp. l240 ◽  
Author(s):  
Matejka Rebolj ◽  
Janet Rimmer ◽  
Karin Denton ◽  
John Tidy ◽  
Christopher Mathews ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Observational Study ◽  
Cervical Intraepithelial Neoplasia ◽  
Cervical Screening ◽  
Intraepithelial Neoplasia ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Liquid Based Cytology ◽  
Grade 3

AbstractObjectiveTo provide the first report on the main outcomes from the prevalence and incidence rounds of a large pilot of routine primary high risk human papillomavirus (hrHPV) testing in England, compared with contemporaneous primary liquid based cytology screening.DesignObservational study.SettingThe English Cervical Screening Programme.Participants578 547 women undergoing cervical screening in primary care between May 2013 and December 2014, with follow-up until May 2017; 183 970 (32%) were screened with hrHPV testing.InterventionsRoutine cervical screening with hrHPV testing with liquid based cytology triage and two early recalls for women who were hrHPV positive and cytology negative, following the national screening age and interval recommendations.Main outcome measuresFrequency of referral for a colposcopy; adherence to early recall; and relative detection of cervical intraepithelial neoplasia grade 2 or worse from hrHPV testing compared with liquid based cytology in two consecutive screening rounds.ResultsBaseline hrHPV testing and early recall required approximately 80% more colposcopies, (adjusted odds ratio 1.77, 95% confidence interval 1.73 to 1.82), but detected substantially more cervical intraepithelial neoplasia than liquid based cytology (1.49 for cervical intraepithelial neoplasia grade 2 or worse, 1.43 to 1.55; 1.44 for cervical intraepithelial neoplasia grade 3 or worse, 1.36 to 1.51) and for cervical cancer (1.27, 0.99 to 1.63). Attendance at early recall and colposcopy referral were 80% and 95%, respectively. At the incidence screen, the 33 506 women screened with hrHPV testing had substantially less cervical intraepithelial neoplasia grade 3 or worse than the 77 017 women screened with liquid based cytology (0.14, 0.09 to 0.23).ConclusionsIn England, routine primary hrHPV screening increased the detection of cervical intraepithelial neoplasia grade 3 or worse and cervical cancer by approximately 40% and 30%, respectively, compared with liquid based cytology. The very low incidence of cervical intraepithelial neoplasia grade 3 or worse after three years supports extending the screening interval.

Trends in the Prevalence of Cervical Intraepithelial Neoplasia Grade 3 in the District of Florence, Italy

1995 ◽  
Vol 81 (5) ◽  
pp. 330-333 ◽  
Author(s):  
Silvia Cecchini ◽  
Stefano Ciatto ◽  
Marco Zappa ◽  
Annibale Biggeri
Keyword(s):  
Cervical Cancer ◽  
Cervical Intraepithelial Neoplasia ◽  
Poisson Regression ◽  
Precancerous Lesions ◽  
Age Groups ◽  
Pap Test ◽  
Intraepithelial Neoplasia ◽  
Birth Cohorts ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Detection Rates

Aims and background The objective of this study was to investigate the detection rate of cervical intraepithelial neoplasia grade III (CIN 3) in previously unscreened women, in order to reveal trends over time in the prevalence of CIN 3 in the District of Florence, where a population-based screening for cervical cancer has been going on since 1973. Study design We considered the women, recorded in the computerized archives of CSPO, who had had no pap test for at least 10 years. Trends of CIN 3 (histologically proven) were analyzed within age groups; the effect of age, cohort and period were considered by means of a Poisson regression model. Results A total of 648 cases of histologically proven CIN 3 were detected in the study period. The detection rates of CIN 3 increased steadly within age groups over birth cohort and calendar period simultaneously. The Poisson regression analysis showed that only the model with age + time trend was statistically significant. Conclusions Although several biases should be taken into account, the analysis seemed to indicate a real increase in CIN 3 prevalence. An increase in frequency of precancerous lesions for cervical cancer in more recent birth cohorts supports the need to keep screening coverage and efficiency as high as possible.

scholarly journals HPV Detection Methods

2007 ◽  
Vol 23 (4) ◽  
pp. 273-281 ◽  
Author(s):  
Antoinette A. T. P. Brink ◽  
Peter J. F. Snijders ◽  
Chris J. L. M. Meijer
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Cervical Intraepithelial Neoplasia ◽  
Causal Relation ◽  
Cervical Screening ◽  
Intraepithelial Neoplasia ◽  
Detection Methods ◽  
High Grade ◽  
Cervical Lesions

Given the causal relation between a persistent high-risk human papillomavirus (hrHPV) infection and the development of high-grade cervical intraepithelial neoplasia (CIN) and cervical cancer, hrHPV testing has been advocated in addition to cytology for the detection of clinically relevant cervical lesions. HrHPV testing is thought to improve cervical screening algorithms, the management of women with cytologically equivocal smears, and the management of women treated for high grade CIN. In this chapter we discuss different methods for HPV detection and genotyping and their respective applications.

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