Human Papillomavirus (HPV)

2021 ◽  
Author(s):  
Anne Schuind
Keyword(s):  
Cervical Cancer ◽  
Neutralizing Antibodies ◽  
Invasive Cervical Cancer ◽  
Cancer Control ◽  
Middle Income ◽  
Middle Income Countries ◽  
Common Cancer ◽  
Associated Lesions ◽  
Hpv Types ◽  
E6 And E7

HPV is extremely common worldwide and mainly transmitted through sexual contact; most people are infected with HPV shortly after onset of sexual activity. There are >200 types of HPV, of which at least 12 are cancer-causing (oncogenic or high-risk types). HPV is a causal factor for several anogenital and a subset of oropharyngeal cancers with 2 HPV types (16 and 18) causing 72% of all HPV-associated cancers. Cervical cancer is the fourth most common cancer among women globally with nearly 90% of the deaths occurring in low- and middle-income countries. Comprehensive cervical cancer control includes primary prevention (vaccination against HPV), secondary prevention (screening and treatment of pre-cancerous lesions) as well as treatment of invasive cervical cancer. The currently licensed vaccines are L1 VLP-based and prophylactic; they have been shown to be safe and highly effective in preventing HPV infections and HPV-associated lesions, precancer and cancer. Neutralizing antibodies are the mechanism of protection for prophylactic HPV VLP-based vaccines. Therapeutic HPV vaccines targeting the oncoproteins E6 and E7 are in clinical development.

scholarly journals Cervical Cancer in the Greater Accra and Ashanti Regions of Ghana

2017 ◽  
Vol 3 (6) ◽  
pp. 782-790 ◽  
Author(s):  
Yvonne Nartey ◽  
Philip C. Hill ◽  
Kwabena Amo-Antwi ◽  
Kofi M. Nyarko ◽  
Joel Yarney ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Invasive Cervical Cancer ◽  
Tumor Grade ◽  
Mortality Rates ◽  
Teaching Hospitals ◽  
Middle Income ◽  
Middle Income Countries ◽  
Common Cancer ◽  
Incidence And Mortality ◽  
Low And Middle Income

Purpose Cervical cancer is a common cancer among women worldwide. An estimated 528,000 new cases and 266,000 deaths occurred in 2012. More than 85% of invasive cervical cancer cases occur in low- and middle-income countries. Cervical cancer ranks as the most common cancer among women in Ghana. We conducted a retrospective study to assess the descriptive epidemiology of cervical cancer in Ghana. We describe cervical cancer incidence and mortality rates for the regions served by two large hospitals in Ghana. Patients and Methods Information for women diagnosed with invasive cervical cancer between 2010 and 2013 was collected from the Komfo Anokye and Korle Bu Teaching Hospitals through review of medical, computer, and pathology records at the oncology units and the obstetrics and gynecology departments. Telephone interviews were also conducted with patients and relatives. Data were analyzed using summary statistics. Results A total of 1,725 women with cervical cancer were included in the study. Their ages ranged from 11 to 100 years (mean, 56.9 years). The histology of the primary tumor was the basis of diagnosis in 77.5% of women and a clinical diagnosis was made in 22.5% of women. For the 1,336 women for whom tumor grade was available, 34.3% were moderately differentiated tumors. Late stage at presentation was common. The incidence and mortality rates of cervical cancer increased with age up until the 75 to 79–year age group and began to decrease at older ages. The Greater Accra region had higher overall incidence and mortality rates than the Ashanti region. Conclusion Our study suggests that improvements in the application of preventive strategies could considerably reduce the burden of cervical cancer in Ghana and other low- and middle-income countries. The study provides important information to inform policy on cancer prevention and control in Ghana.

scholarly journals Modern possibilities of using immunotherapy in the treatment of cervical cancer

2021 ◽  
Vol 17 (2) ◽  
pp. 104-111
Author(s):  
A. V. Tarasova ◽  
K. A. Ganina ◽  
M. A. Meshkova ◽  
Yu. V. Solovyeva ◽  
E. E. Ivanova ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Clinical Case ◽  
Control Points ◽  
Special Group ◽  
Middle Income ◽  
Vaccination Programs ◽  
Middle Income Countries ◽  
Common Cancer ◽  
Preventive Vaccination

Cervical cancer (CC) is the fourth most common cancer in women worldwide. Every year, more than 500,000 women are diagnosed with CC, and the disease leads to more than 300,000 deaths worldwide. Infection with the human papillomavirus is the cause of CC in most cases. The disease is largely preventable through preventive vaccination. Approximately 90 % of CC cases are diagnosed in low-and middle-income countries where there are no organized human papillomavirus screening and vaccination programs. A special group in this disease consists of patients who develop recurrent / metastatic CC. To date, the most promising direction of drug treatment for this pathology is drugs that act on the control points of immunity – the PD-1 receptor / PD-L1 ligand, which are used by the tumor to block the immune system. The article presents a clinical case demonstrating the efficacy of the PD-1 inhibitor pembrolizumab for the treatment of recurrent / metastatic CC.

scholarly journals Digital Health Strategies for Cervical Cancer Control in Low- and Middle-Income Countries: A Systematic Review of Current Implementations and Gaps in Research (Preprint)

2020 ◽  
Author(s):  
Andrea H. Rossman ◽  
Hadley W. Reid ◽  
Michelle M. Pieters ◽  
Ceclia Mizelle ◽  
Megan von Isenberg ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Health Workers ◽  
Digital Health ◽  
Meta Analysis ◽  
Cancer Control ◽  
Risk Of Bias ◽  
Middle Income ◽  
High Burden ◽  
Middle Income Countries ◽  
Study Designs

BACKGROUND Eight-five percent of deaths due to cervical cancer occur in low- and middle-income countries (LMICs). In recent years, many digital health strategies have been implemented in LMICs to ameliorate patient-, provider-, and health system level challenges in cervical cancer control. Yet, there are limited efforts to systematically review the effectiveness and current landscape of digital health strategies for cervical cancer control in LMICs. OBJECTIVE We aimed to conduct a systematic review of digital health strategies for cervical cancer control in LMICs to assess their effectiveness, describe the range of strategies used, and summarize challenges to their implementation. METHODS A systematic search was conducted to identify publications describing digital health strategies for cervical cancer control in LMICs from five academic databases and Google Scholar. Titles and abstracts were screened and full texts were reviewed for eligibility. A structured data extraction template was used to summarize information from included studies. The risk of bias and data reporting guidelines for mobile health were assessed for each study. A meta-analysis of effectiveness was planned along with a narrative review of digital health strategies, implementation challenges, and opportunities for future research. RESULTS In the 24 included studies, digital health strategies for cervical cancer control focused predominantly on cervical image capture, remote expert review, training health workers, and, less frequently, patient education. Most included studies were implemented in sub-Saharan Africa, with fewer studies in other LMIC regions such as Asia or South America. One study had low risk of bias, and three studies had a moderate risk of bias while the remaining 20 studies had a high risk of bias. Due to insufficient studies with robust study designs, matched outcomes or interventions, a meta-analysis of effectiveness was not possible. Existing strategies used digital health for improving women’s knowledge and awareness about cervical cancer, increasing access to cervical cancer services, improving training of health workers and availability of data, and ensuring continuity of care. Key challenges in implementing digital health strategies for cervical cancer control were related to the high burden of training, technology-specific issues, infrastructure challenges, challenges with technology reach and inequitable access to technology among target users. CONCLUSIONS The current evidence on the effectiveness of digital health strategies for cervical cancer control is limited and, in most cases, is associated with a high risk of bias. Further studies are recommended to expand the investigation of digital health strategies for cervical cancer using robust study designs, explore other LMIC settings with high burden of cervical cancer (e.g., South America), and test a greater diversity of digital strategies. CLINICALTRIAL The review protocol is registered with the PROSPERO database for prospectively registered systematic reviews (Protocol # CRD42017071560).

'Have a Pap smear!' – doctors, their clients, and opportunistic cervical cancer screening

2005 ◽  
Vol 16 (3) ◽  
pp. 233-236 ◽  
Author(s):  
L C Chingang ◽  
U Bischof ◽  
G Andall-Brereton ◽  
O Razum
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Cervical Screening ◽  
Pap Test ◽  
Community Members ◽  
Middle Income ◽  
Middle Income Countries ◽  
High Incidence

In many middle-income countries with a high incidence of cervical cancer, organized screening programmes with the Pap test are being planned. We assessed the knowledge of, and attitudes towards, cervical screening among 63 doctors and 102 randomly selected community members in Trinidad where screening is still opportunistic. Doctors were well informed about cervical cancer, but not all knew the approximate specificity of the Pap test. Many did not routinely discuss the benefits and disadvantages of screening with their clients. Most women had heard of the Pap test, but only 56% knew its purpose; 25% would not participate in screening, stating reasons such as being in menopause or not having symptoms. More information about the aim of screening and the purpose of the Pap test must be communicated. Doctors need to keep their knowledge on screening up-to-date, and offer counselling that helps women to make an informed decision whether or not to participate in screening.

scholarly journals Development of HPV 16/18 E6 oncoprotein paper-based nanokit for enhanced detection of HPV 16/18 E6 oncoprotein in cervical cancer screening

2020 ◽  
Author(s):  
Lucy Muthoni Mwai ◽  
Mutinda C. Kyama ◽  
Caroline W. Ngugi ◽  
Edwin Walong
Keyword(s):  
Cervical Cancer ◽  
Gold Nanoparticles ◽  
Cancer Screening ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Intraepithelial Neoplasia ◽  
Hpv 16 ◽  
Middle Income ◽  
Middle Income Countries ◽  
E6 Oncoprotein

AbstractCervical cancer caused mainly by high risk human papillomavirus (HPV) 16 and 18 strains is the second most prevalent cancer of women in Kenya. It is often diagnosed late when treatment is difficult due to very low percentage of women attending screening thus, mortalities remain high. The most available tests in low-and-middle-income countries (LMICs) have relatively low specificity, low sensitivity, require a laboratory setting and huge technical and financial support not readily available. HPV 16/18 E6 oncoprotein has been identified as a potential biomarker in a more specific early diagnosis of cervical cancer. This retrospective cross-sectional study developed a paper-based nanokit with enhanced detection of HPV 16/18 E6 oncoprotein for cervical cancer screening. The HRP labelled antibodies HPV 16 E6/18 E6-HRP (CP15) passively conjugated to citrate stabilized 20nm gold nanoparticles were evaluated for immune sensing mechanism using a recombinant viral HPV E6 protein. The diagnostic accuracy was evaluated using 50 tissue lysates from formalin fixed paraffin embedded cervical biopsy, including control (n=10), Mild Dysplasia (n=10), Cervical intraepithelial neoplasia 3 (CIN3) (n=10), Cervical intraepithelial neoplasia 4 (CIN4) (n=10) and invasive carcinoma (n=10). The molecular technique used was dot blot molecular assay. A positive result was generated by catalytic oxidation of peroxidase enzyme on 3,3’,5,5’-Tetramethylbenzidine (TMB) substrate. The gold nanoparticles were used to enhance the signal produced by peroxidase activity of horseradish peroxidase (HRP) enzyme giving a more sensitive assay as compared to use of non-conjugated antibody. This study provides a significantly high and reliable diagnostic accuracy for precancerous and cancerous lesions with a sensitivity of 90%, a specificity of 90%, a likelihood ratio for positive and negative tests as 9:1 and 1:9 respectively, a Positive Predictive Value of 97.3% and a Negative Predictive Value of 69.2%. This study avails a sensitive, rapid test using paper-based nanotechnology which can be utilised in community-based screening outreaches particularly in low- and middle-income countries.

scholarly journals Antibodies against Early Proteins of Human Papillomaviruses as Diagnostic Markers for Invasive Cervical Cancer

1998 ◽  
Vol 36 (2) ◽  
pp. 475-480 ◽  
Author(s):  
Wolfgang Meschede ◽  
Klaus Zumbach ◽  
Joris Braspenning ◽  
Martin Scheffner ◽  
Luis Benitez-Bribiesca ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Invasive Cervical Cancer ◽  
Human Papillomaviruses ◽  
Antibody Detection ◽  
Diagnostic Tools ◽  
Immunological Monitoring ◽  
Hpv Dna ◽  
Native Proteins ◽  
Human Sera ◽  
E6 And E7

Cervical cancer is the most prevalent tumor in developing countries and the second most frequent cancer among females worldwide. Specific human papillomaviruses (HPVs) and, most notably, HPV types 16 and 18 are recognized as being causally associated with this malignancy. Antibodies against early HPV proteins E6 and E7 have been found more often in patients with tumors than in controls. Existing peptide enzyme-linked immunosorbent assays (ELISAs) for the detection of anti-E6 and anti-E7 antibodies in human sera have low levels of sensitivity and specificity and thus are not suitable for use as diagnostic tools. Based on highly purified recombinant native proteins, we developed four sandwich ELISAs for the detection of antibodies against HPV type 16 and 18 E6 and E7 proteins. We demonstrate their sensitivities and high degrees of specificity for cervical cancer. Among a total of 501 serum specimens from unselected patients with invasive cervical cancer, 52.9% reacted positively in at least one of the four assays. In contrast, among 244 serum specimens from control subjects without cervical cancer, only 2 reactive serum specimens (0.8%) were found. For 19 of 19 antibody-positive patients, the HPV type indicated by seroreactivity was identical to the HPV DNA type found in the tumor, which also indicates a high degree of specificity for antibody detection with respect to HPV type. In a direct comparison of 72 serum specimens from patients with cervical cancer, 56% of the specimens reacted in at least one of the four protein ELISAs, whereas 40% reacted in at least one of seven peptide ELISAs covering the four antigens. These assays could be of value for the detection of invasive cervical cancer in settings in which cytology-based early tumor screening is not available, for the clinical management of patients diagnosed with cervical cancer, and for the immunological monitoring of E6 and E7 vaccination trials.

Human papillomavirus (HPV) vaccination: from clinical studies to immunization programs

2019 ◽  
Vol 29 (8) ◽  
pp. 1317-1326 ◽  
Author(s):  
Raúl Murillo ◽  
Camila Ordóñez- Reyes
Keyword(s):  
Cervical Cancer ◽  
Clinical Trials ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Population Based ◽  
Immunization Programs ◽  
Hpv Vaccines ◽  
Middle Income ◽  
Middle Income Countries

Cervical cancer incidence and mortality have decreased in high-income countries, but low- and middle-income countries continue to bear a significant burden from the disease. Human papillomavirus (HPV) vaccines are a promising alternative for disease control; however, their introduction is slow in settings with greater need. We conducted a review of HPV vaccine efficacy and effectiveness reported in clinical trials and population-based studies. Efficacy of HPV vaccines is close to 100% when using a three-dose schedule in HPV-negative young women (<25 years old) for protection against persistent infection and HPV vaccine-type associated pre-cancerous lesions. Furthermore, sustained protection for up to 12 years of follow-up has been demonstrated; cross-protection against non-vaccine types is particularly observed for the bivalent vaccine, and preliminary data regarding impact on invasive cancer have emerged. Given its lower efficacy, catch-up vaccination beyond 19 years of age and proposals for vaccinating adult women deserve careful evaluation in accurately designed studies and economic analyses. Despite positive results regarding immunogenicity and post-hoc analysis for cervical intra-epithelial neoplasia in clinical trials, population-based data for prime and booster two-dose schedules are not available. Evaluation of vaccine safety from surveillance systems in immunization programs that have already distributed more than 270 million doses found no association of HPV vaccination with serious side effects. The introduction of HPV vaccination in national immunization programs remains the main challenge in tackling the burden of cervical cancer (up to 2018, only 89 countries have introduced vaccination worldwide, and most of these are high-income countries). Access models and technical capacity require further development to help low- and middle-income countries to increase the pace of vaccine delivery. Alternative approaches such as one-dose schedules and vaccination at younger ages may help reduce the programmatic and economic challenges to adolescent vaccination.

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