scholarly journals Cervical Cancer Elimination by 2030: The “SMASH” Strategy of Raj © A Global Public Health Treatise

2021 ◽  
Author(s):  
Rajamanickam Rajkumar
Keyword(s):  
Public Health ◽  
Cervical Cancer ◽  
Tamil Nadu ◽  
Pap Smear ◽  
Hpv Vaccination ◽  
Test Methods ◽  
Screening Tests ◽  
Global Public Health ◽  
Dna Test ◽  
Hpv Dna

Cervical cancer is a leading cancer among women, being the second most gynecological cancers in the developing countries, accounting for about 6 million new cases every year and 3.5 million deaths. The Cervical cancer is easily detectable by simple screening tests, like visual inspection methods, pap smear examination, and the recent HPV DNA test methods. If the precancer conditions are diagnosed, treatment can be done by ablation or excisional methods. The women can be followed by periodic cervical biopsy examinations, ideally once in 6 months for 3 years. If, at the end of 3 years, there is no evidence of cervical precancer, then the women will not develop invasive cancer stages. The HPV vaccination of adult and adolescent girls, offer more than 90% protection against Cervical Cancer. Thus, Cervical cancers are early detectable, effectively treatable and successfully preventable. The author, having been the Principal Investigator for one of the largest Cervical Cancer Screening programs in India, atAmbillikai, Tamil Nadu, India, during 2000–2007, which was in collaboration with the International Agency for Research on Cancer – IARC / WHO. The program was successful in reducing the Incidence Rate of Cervical Cancer by 25% and Mortality Rate due to Cervical Cancer, by 35% in a span of 5 years. From the experiences of this “Proof of Concept” project, the author has advocated, “SMASH” strategy of Raj©, for Cervical Cancer Elimination by 2030, which is deliberated in detail, i n this chapter. Hope that, this will serve as a Global Public Health Treatise, for the health care planners and providers in particular and the community at large, worldwide.

scholarly journals Efficiency of HPV DNA Test versus Pap Smear in the Screening of Cervical Cancer

2018 ◽  
Vol 1 (2) ◽  
pp. 9-13
Author(s):  
Renee Pradhan ◽  
U. Pant ◽  
B. Aryal
Keyword(s):  
Cervical Cancer ◽  
Cervical Intraepithelial Neoplasia ◽  
Pap Smear ◽  
Intraepithelial Neoplasia ◽  
Cervical Neoplasia ◽  
Hpv Testing ◽  
Dna Test ◽  
Hpv Dna ◽  
Smear Testing ◽  
Hpv Dna Test

Introduction: Cancer cervix is a common genital cancer. Human papillomavirus is the main cause of cervical cancer because of the strong association of certain HPV genotypes and the development of cervical cancer and its precursor lesions, cervical intraepithelial neoplasia CIN 2 or CIN3. Methods: The study was conducted on 180 gynecological patients seen at the outpatient department of Manipal Hospital, Bangalore. A comparative study of HPV DNA test with Pap smear in the screening of cervical neoplasia was carried out over the period of 24 months from August 2011 to June 2013. Results: The incidence of cervical cancer and its associated mortality has declined in recent years, largely due to the widespread implementation of screening programs by Pap smear testing. The management and the prevention of cervical cancer should change with HPV DNA testing for high risk HPV, which is more sensitive than pap smear testing. Infection of cervix with HPV is necessary to cause cervical neoplasia and cervical cancer. Persistent infection with HPV is required for the development of cervical dysplasia and invasive cervical cancer. Conclusions: HPV testing alone for primary screening appears promising in women aged 30 years and older as this group is at greatest risk of developing CIN 3. As compared with Pap testing, HPV testing has greater sensitivity for detection of cervical intraepithelial neoplasia.

scholarly journals Onkogenesis, Morfologi, dan Modalitas Deteksi Dini Karsinoma Serviks

2021 ◽  
Vol 3 (1) ◽  
pp. 47
Author(s):  
Elsani P. L. Rapar ◽  
Maria K. Sambuaga ◽  
Meilany F. Durry
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Early Detection ◽  
Cervical Carcinoma ◽  
Pap Smear ◽  
Morphological Changes ◽  
Screening Tests ◽  
Pap Smears ◽  
Hpv Dna ◽  
E6 And E7

Abstract: The incidence and mortality rates of cervical cancer in developing countries are relatively high compared to developed countries. The main risk factor for cervical cancer is high risk human papilloma virus (HPV) infection, such as types 16 and 18. Types of high-risk HPV expresses oncoproteins E6 and E7 which play an essential role in the pathogenesis of cervical carcinoma through inhibition of the activity of gene group expression products that play a role in suppressing tumor growth, such as p53 and pRB. This process will cause morphological changes in the squamous epithelium from precancerous lesions to cancer. The development of squamous epithelial cell cancer can be prevented through screening tests in order to detect cervical cancer early. This study was aimed to obtain the oncogenesis, morphology, and early detection modality of cervical carcinoma. This was a literature review study using three databases, as follows: ClinicalKey, PubMed, and Google Scholar. The results explained that p53 and pRB suppression by high-risk HPV oncoproteins E6 and E7 played an important role in the pathogenesis of cervical carcinoma. The most common histological type is squamous cell carcinoma. Screening tests such as visual inspection with acetic acid (VIA), Pap smears and HPV DNA have an important role as modalities for early detection of malignancy. More specifically VIA and Pap smears are suitable for Indonesia which is a developing country, especially when implemented in peripheral areas.Keywords: oncogenesis; morphological changes; early detection; cervical carcinoma  Abstrak: Insidens dan mortalitas kanker serviks di negara berkembang relatif tinggi dibandingkan negara maju. Faktor risiko utama dari kanker serviks adalah infeksi human papilloma virus (HPV) risiko tinggi yaitu tipe 16 dan 18. HPV tipe risiko tinggi mengekspresikan onkoprotein E6 dan E7, yang berperan penting dalam patogenesis karsinoma serviks melalui inhibisi terhadap aktivitas produk-produk ekspresi kelompok gen yang berperan dalam menekan pertumbuhan tumor, seperti p53 dan pRB. Proses ini akan menyebabkan perubahan morfologik pada epitel skuamosa mulai dari lesi prakanker sampai kanker. Perkembangan kanker sel epitel skuamosa dapat dicegah melalui pemeriksaan skrining guna mendeteksi dini kanker serviks. Penelitian ini bertujuan untuk mengetahui onkogenesis, morfologi, dan modalitas deteksi dini karsinoma serviks. Jenis penelitian ialah literature review menggunakan tiga basis data yaitu ClinicalKey, PubMed, dan Google Scholar. Hasil penelitian mendapatkan bahwa penekanan p53 dan pRB oleh onkoprotein HPV risiko tinggi E6 dan E7 sangat berperan penting dalam patogenesis karsinoma serviks. Tipe histologik tersering ialah tipe karsinoma sel skuamosa. Pemeriksaan skrining seperti pemeriksaan inspeksi visual dengan asam asetat (IVA), Pap smear dan HPV DNA memiliki peran penting sebagai modalitas deteksi dini keganasan. Lebih khusus IVA dan Pap smear cocok untuk negara Indonesia yang merupakan negara berkembang, terutama bila diimplementasikan di daerah perifer.Kata kunci: onkogenesis; perubahan morfologik; deteksi dini; karsinoma serviks

scholarly journals Knowledge attitude and practices about cervical cancer among urban women working in BPO in Chennai, India

2021 ◽  
Vol 8 (3) ◽  
pp. 1252
Author(s):  
Nilofur Banu ◽  
Azarudheen S.
Keyword(s):  
Cervical Cancer ◽  
Tamil Nadu ◽  
Pap Smear ◽  
Hpv Vaccination ◽  
Urban Women ◽  
Vital Role ◽  
Common Source ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Study Participants

Background: Worldwide cervix cancer ranks fourth place among all the cancer affecting women and commonest cause of death due to cancer among women in developing countries. Business process outsourcing sector in India is a relatively new industry with each growth there is also various negative health issue emerge among people working in those sectors some risk factors associated with ca cervix. Aim of the study was to knowledge, attitudes and practices (KAP) toward cervical cancer, HPV vaccination and screening practice among urban women working in BPO in Chennai.Methods: A cross sectional study was conducted among urban women working in a BPO in Chennai, Tamil Nadu. A face-to-face interview was conducted using a structured questionnaire by the team leader who was train to interview before starting the study.Results: Among 155 female study participants only 46% of the respondents knew about cervix. Among the study participants who knew about cervix and cervical cancer, internet (26%) and TV/Radio (26%) were the most common source of information. Only 4% of respondent heard of Pap smear and none of them had undergone it. Similarly, only 3.73% of the respondents knew about vaccines that are available for Cancer Cervix.Conclusions: The findings of study will help us in planning focused health measures about CA cervix and its prevention strategies .Health awareness will play a vital role in reducing risks of casualties caused by diseases like cancer Cervix.

scholarly journals Cervical Cancer Screening Guidelines in the Postvaccination Era: Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Carlo A. Liverani ◽  
Jacopo Di Giuseppe ◽  
Luca Giannella ◽  
Giovanni Delli Carpini ◽  
Andrea Ciavattini
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Hpv Vaccination ◽  
Screening Strategy ◽  
Cervical Cancer Prevention ◽  
Dna Test ◽  
Hpv Dna ◽  
Screening Guidelines ◽  
Screening Programs

Cervical cancer is relatively rare in high-income countries, where organized screening programs are in place, as well as opportunistic ones. As the human papillomavirus (HPV) vaccination rates increase, the prevalence of cervical precancers and cancers is going to decrease rapidly very soon, even if, in the most optimistic scenario, it is unlikely that optimal vaccination coverage will be achieved. Then, the optimal screening paradigm for cervical cancer prevention in the postvaccination era is still debated. Screening guidelines are being developed with the aim of reducing the number of tests a woman needs during her lifetime, in order to receive the maximum benefit from screening, while decreasing potential harms that may result with the use of a screening strategy (overdiagnosis, overtreatment, anxiety, and costs). With this purpose in mind, new management guidelines for cervical cancer screening abnormalities are recommendations based on risks, not on results. This review aims to summarize the process that led to the introduction of the HPV DNA test in screening programs and the different screening strategies. Moreover, it aims to introduce the new risk-based guidelines for the future, where full HPV genotyping can resize the risk on the basis of specific high-risk genotypes. In the same way, the data regarding HPV vaccination could be introduced as soon as women vaccinated with the nonavalent vaccine reach the screening age, with the recommendation of a prolonged screening interval.

scholarly journals Correlation of HPV-DNA Test with Cytology and Histology for the Diagnosis of Cervical Cancer and Precancerous Lesions in a Tertiary Care Hospital in Bangladesh

2017 ◽  
Vol 13 (1) ◽  
pp. 103-105
Author(s):  
Shamina Islam ◽  
Md Nizam Uddin ◽  
Nasima Akter ◽  
Tarana Tabashum ◽  
Maznun Us Sadakin ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Precancerous Lesion ◽  
Care Hospital ◽  
Hybrid Capture ◽  
Dna Test ◽  
Hpv Dna ◽  
Cancerous Lesion ◽  
Hybrid Capture 2 ◽  
Hpv Dna Test

Introduction: Cervical cancer is the second most prevalent cancer among women worldwide. High-Risk Human Papilloma virus (hr-HPV) is an established cause of cervical cancer and precancerous lesion. Studies have shown the relationship between the HPV-DNA test with cervical precancerous and cancerous lesion in diagnosing cervical cancer. This study aimed to correlate HPV-DNA test with both cytology and histology. Objective: To find out the correlation of HPV-DNA test with cytology and histology for the diagnosis of cervical precancerous and cancerous lesion. Materials and Methods: Cervical smears and DNA samples were collected from the selected patients attending the colposcopy clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) from July 2011 to April 2013. Biopsy was done on colposcopically positive cases and histopathology reports were obtained. Thus 99 histologically proven patients of cervical cancer and precancerous lesion were selected. Pap smear was carried out on these 99 patients. HPV-DNA test (Hybrid Capture-2 assay) was carried out on the same samples and viral loads were estimated. Results: Among the 99 cases, 28(28.28%) cases were positive with Hybrid Capture-2(HC-2) assay. Out of 60 cases of CIN-I (Cervical Intraepithelial Neoplasia-1), 7(11.7%) cases were positive with HC-2. Among others, 3(15.0%) cases of CIN-II were positive with HC-2. The viral load was very high in invasive SCC (squamous cell carcinoma) cases in contrast to other categories of histological and cytological diagnosis. A significant relationship was observed between HC-2 and histological diagnosis (P<0.005); and between HC-2 and Pap smear (P<0.005). Conclusion: Introduction of HC-2 where possible along with Pap smear would be highly effective in primary screening and subsequent follow up of cervical precancerous and cancerous lesion. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 103-105

scholarly journals Knowledge and awareness of cervical cancer, its screening and HPV vaccination among out patients in a tertiary care institute in India

2019 ◽  
Vol 6 (10) ◽  
pp. 4437
Author(s):  
Devi Balasubramaniam ◽  
Kavitha Yogini Duraisamy ◽  
Sangeetha Karunanithi
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Tamil Nadu ◽  
Pap Smear ◽  
Public Awareness ◽  
Hpv Vaccination ◽  
Tertiary Care ◽  
Screening Method ◽  
Research Centre ◽  
Indian Women

Background: Cervical cancer, despite being a preventable disease, its screening and vaccination still remains poor in our country. The aim of our study was to assess the knowledge and awareness regarding cervical cancer, its risk factors, screening and HPV vaccination.Methods: This cross sectional study was carried out among outpatients attending gynaecology OPD in GEM hospital and Research Centre, a tertiary care centre in Tamil Nadu during the period of April 2019 to June 2019. A total of 500 women, aged 16 years and above were analyzed using a structured questionnaire with multiple choices regarding socio demographic profile, knowledge and awareness about the cervical cancer, its risk factors, screening method and HPV vaccination.Results: Only 16.6% knew that cervical cancer is the most common cancer in Indian women. Majority (74.6%) of them were married, of which 36.2% were aware of Pap smear. Of those who were aware, only one third (12.6%) had their Pap smear done. The awareness of HPV vaccination was only 25% and 3.4% of them were vaccinated. 70.2% of the study participants were willing to be vaccinated after knowing about the vaccination.Conclusions: This study serves to highlight that, the majority of women lack knowledge and awareness concerning cervical cancer and its preventive aspects. This is a major hindrance among Indian women to undergo early screening and timely prevention. Hence creating public awareness of cervical cancer and its prevention is still a priority. 

Cervical Cancer Prevention and Screening

2017 ◽  
Author(s):  
Carolyn D. Runowicz ◽  
Andrew Quinn
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Gynecological Cancer ◽  
Cervical Cancer Prevention ◽  
Hpv Dna ◽  
Screening Guidelines ◽  
Hpv Dna Testing ◽  
Cancer Prevention And Screening ◽  
Screening And Prevention ◽  
New Guidelines

With the advent of HPV DNA testing and the availability of HPV vaccinations, the recommendations and rationale for screening and prevention of cervical cancer and its precursors have undergone revision, reflecting this new knowledge and understanding of cervical intra-epithelial neoplasia and the role of HPV. This review incorporates the new guidelines and rationale for current screening guidelines for cervical cancer and in the management of patients with atypical or unsatisfactory cervical cytology. This review contains 4 figures, 2 tables, and 69 references. Key words: Cervical cancer, Gynecological cancer, HPV, HPV testing, HPV vaccine, Pap smear, HPV DNA, Human papillomavirus

Evaluation of Cervical Cancer Screening Tools; INNO-LiPA® HPV Genotyping Extra-II Assay versus E7/E6 oncoproteins, How is reliable and practical?

2021 ◽  
Vol 15 (5) ◽  
pp. 1276-1281
Author(s):  
R. Bahramabadi ◽  
M. K. Arababadi ◽  
M. Iranpour ◽  
E. Mohebbi ◽  
Z. Honarvar ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Western Blot ◽  
Pap Smear ◽  
Diagnostic Methods ◽  
Screening Tools ◽  
Hpv Dna ◽  
Hpv Genotyping ◽  
Hpv E7 ◽  
Diagnostic Values

Background: High-Risk Human papillomavirus (HR-HPV) has been well established as the cervical cancer (CC) risk factor. In recent years, various diagnostic methods of human papillomaviruses (HPV) have been developed to promote sensitivity and specificity of CC screening which leads to a low mortality rate. This study aimed to compare diagnostic test metrics of two HPV diagnostic techniques, including Western blot and INNO-LiPA HPV Genotyping Extra II assay methods in asymptomatic or subclinical patients, among the South-Eastern Iranian women. Methods: 323 women were referred to the Pathology and Stem Cell Research Center, from February 2018 to January 2020. HPV-DNA with the INNO-LiPA HPV Genotyping Extra-II Assay kit and the western blot assays for HPV E7 and E6 assessment were employed. Results: Overall, 163 (50.4%) samples were dysplastic pap smear, the specificity of the HPV DNA test by INNO-LiPA HPV Genotyping Extra-II Assay test was significantly higher than the E7/E6 oncoproteins finding (67.3 vs. 49.9%), and the sensitivity was lower (96.6 vs. 74.8%), respectively. Conclusions: HR-HPV E7/E6 oncoproteins expression was evaluated as a possible novel biomarker for CC screening in pap smear as the preliminary test with satisfactory diagnostic values for HR-HPV types 16 and 18. The corresponding diagnostic values may be further improved by combining HPV DNA tests with the INNO-LiPA HPV Genotyping Extra-II test. Also, they may prove helpful for HR-HPV infection diagnosis in cases that the patients are asymptomatic or subclinical. Keywords: Cervical Cancer; Human Papillomavirus (HPV); Diagnostic Screening Programs; Oncogene Proteins

scholarly journals Estimating the public health impact of a national guideline on cervical cancer screening: an audit study of a program in Campinas, Brazil

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Diama Bhadra Vale ◽  
Talita Lourenço Menin ◽  
Joana Froes Bragança ◽  
Julio Cesar Teixeira ◽  
Lucas Almeida Cavalcante ◽  
...  
Keyword(s):  
Public Health ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Health Impact ◽  
Screening Tests ◽  
The Public ◽  
Frequent Interval ◽  
Cancer Screening Tests ◽  
First Time

Abstract Background A Brazilian guideline on cervical cancer screening was released in 2011. The objective was to verify changes in screening indicators around this period. Methods An audit study which sample was all screening tests performed by the public health system of Campinas city from 2010 to 2016. Variables were absolute tests numbers, excess tests, intervals and results, by age. For trend analysis was used Cochran-Armitage × 2 and linear regression. Results Were carried out 62,925 tests in 2010 and 43,523 tests in 2016, a tendency at a reduction (P = 0.001). Excess tests were higher than 50% over the years, with a tendency at a reduction (P < 0.001). Tests performed on women under 25 ranged from 20.2 to 15.4% in the period (P < 0.001), while in the 25–64 years age-group, it ranged from 75.1 to 80.2% (P < 0.001). In 2010 the most frequent interval was annual (47.5%) and in 2016 biennial (34.7%). There was a tendency at a reduction in the proportion of tests performed at the first time and those with an annual interval (P < 0.001), and also a tendency at an increase in tests with intervals equal to or greater than biannual (P < 0.001). We observed a tendency at a reduction in LSIL and HSIL-CIN2 results (P = 0.04 and P = 0.001, respectively), and a tendency at an increase in HSIL-CIN3 result (P = 0.02). Conclusion The proportion of cervical cancer screening tests performed out of the recommendation showed a significant reduction in the period. This indicates a tendency to align cervical cancer screening in Campinas with the standards recommended.

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