• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.897-900
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• 2012

Cervical cancer resulting from prior infection with human papillomavirus (HPV) is a significant public health threat against young Japanese women. A national immunization plan to vaccinate 13~16 year old female students against HPV infection has been started in Japan since 2010, and may reach almost full coverage by the end of 2012. Older age females who may already be sexually active are not targeted by this plan but should follow safer sex practices as well as periodic screening of the cervix cytology to reduce their risk of developing cervical cancer. HPV vaccination alone does not offer full protection either, because only some HPV types are covered by the vaccines and the long-term efficacy of the vaccines has not been determined yet. Therefore, we did a survey at an international university in Japan to study the knowledge and attitude of female college students towards prevention of cervical cancer, to examine the age when they start sexual activity and other related attributes that may influence the risk of cervical cancer. We discuss the results of our survey and what they imply for the possible impact of an HPV immunization plan on the risk of cervical cancer in Japan, and conclude by an emphasis on the need to increase awareness among Japanese female adolescents and to enhance the cervical screening rates among older females who are already sexually active.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5993-5999
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• 2015

Background: Molecular testing for human papillomavirus (HPV) is the most objective and reproducible of all cervical cancer screening tests and also less demanding in terms of training and quality assurance. However, there is an impending need for cost effective molecular HPV testing methods with sampling ease, easy storage measures and minimum turn around times suitable for a low resource setting. Objective : Our aim was to evaluate the feasibility of using a fast transfer analysis (FTA) mini elute cartridge for cervical sampling to identify high risk HPV by real time PCR and to compare molecular HPV testing and Pap cytology testing to predict histologically confirmed cervical precancer (CIN 2+ lesions) in a cervical cancer prevention program. Materials and Methods: This was conducted as a pilot study (n=200) on women sampled using FTA mini elute cartridges, genotyped by two different real time PCR assays, detecting 13 high risk HPV (HR HPV) species, including HPV16 along with its physical DNA status. Results obtained from each of the tests were compared and analysed using suitable statistical tests. Results: With FTA mini elute cartridge samples HR HPV positivity was seen in 48/200 (24%). Of these, presence of HPV 16 DNA was observed in 28/48 (58.3%) women. High risk HPV was positive in 20% (37/185) of women with benign cytology and 73.3% (11/15) of women with abnormal cytology findings. A very significant correlation (${\chi}^2=22.090$ ; p=0.000) was observed between cytology and HR HPV findings showing an increasing trend of HR HPV prevalence in 50% (1/2) of LSIL, 75% (3/4) of HSIL and 100% (3/3) of SCC. Of the CIN 2+ lesions identified by histopathology, 88.9% (8/9) had HR HPV. A significant association (${\chi}^2=11.223$ ; p=0.001) of HR HPV and histopathologically confirmed CIN 2+ lesions was found. Sensitivity of the two tests were comparable but specificity of Pap testing was better (90.7% vs 70.4%) to predict histopathologically diagnosed cervical precancers. Conclusions: The current study explored the feasibility of using a FTA mini elute cartridge for cervical sampling for the first time in India as a part of a community based cervical cancer prevention program. We suggest that FTA based sampling is suitable and feasible for real time based HPV testing. Molecular HR HPV testing can be more sensitive and useful to identify high risk women requiring Pap testing which is more specific to detect histologically confirmed cervical precancer.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3955-3961
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• 2013

Background: Defects of manganese superoxide dismutase (MnSOD) have long been implicated in generation of oxidative stress and risk susceptibility to various cancers. Two functional polymorphisms within the MnSOD gene, including the Val-9Ala of the mitochondrial targeting sequence (MTS) and the Ile58Thr of the exon-3, have been proposed to reduce its enzyme activity and antioxidant potential. Materials and Methods: A high-throughput multiplex SNaPshot$^{(R)}$ system was developed herein for simultaneous analyses of Val-9Ala and Ile58Thr in a single reaction. Genomic DNA extracted from each whole blood sample of 248 patients including 107 with cervical cancer and 141 with breast cancer and from 136 healthy women as controls was analyzed by the multiplex SNaPshot$^{(R)}$ system. Results: The Val/Val, Val/Ala genotypes and the Val allele of the MTS were predominant in patients with cervical or breast cancer as well as healthy women in Thailand. The Ile/Ile genotype and the Ile allele of the exon-3 were found in all of them whereas none of the Ile/Thr, the Thr/Thr genotypes and the Thr allele was detected. Genotypic association of both Val-9Ala and Ile58Thr polymorphisms with cervical cancer and breast cancer of these patients comparing to healthy women was not statistically significant (p<0.05). Conclusions: The Val/Val, Val/Ala genotypes and the Val allele of the MTS were found predominantly but the Ile/Ile genotype and the Ile allele of the exon-3 were detected in patients with cervical cancer, breast cancer and healthy women in Thailand. These two functional polymorphisms (Val-9Ala and Ile58Thr) in MnSOD gene did not associate with susceptibility risk of these cancer patients in Thailand.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.505-511
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• 2007

Objectives : While cervical cancer is one of the leading cancers among women worldwide, there are a number of effective early detection tests available. However, the participation rates in cervical cancer screening among Korean women remain low. After the nationwide efforts in 1988 and thereafter to encourage participation in cervical cancer screening, few studies have investigated the effects of socioeconomic inequality on participation in cervical cancer screening. The purpose of this study was to investigate 1) the level of socioeconomic disparities in receiving cervical cancer screening by age group and 2) if there was an improvement in reducing these disparities between 1995 and 2001. Methods : Using data from the Korean National Health Status, Health Behavior and Belief Survey in 1995, the Korean National Health and Nutrition Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283), age-standardized participation rates were calculated according to education level, equivalized household income, and job status. Odds ratios and the relative inequality index (RII) were also calculated after controlling for age. Results : Women with lower education levels were less likely to attend the screening test, and the disparities by education level were most pronounced among women aged 60 years and older. The RIIs among women 60 years and older were 3.64, 4.46, and 8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were reported among those in the highest income category, which was more notable among the middle aged women (40s and 50s). An inconsistent trend in the rate of participation in cervical cancer screening by occupational level was found. Conclusions : Indicators of socioeconomic position seem to have varying impacts on the inequalities in the rates of participation in cervical cancer screening according to age group. These results demonstrate the need for more aggressive and age-based interventions and policy programs to eliminate the remaining inequalities.

• BMB Reports
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• v.55 no.9
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• pp.429-438
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• 2022

Cervical cancer is the fourth most common malignancy in women worldwide. Although infection from human papillomavirus (HPV) has been the leading cause of cervical cancer, HPV-negative cervical cancer accounts for approximately 3-8% of all cases. Previous research studies on cervical cancer have focused on HPV-positive cervical cancer due to its prevalence, resulting in HPV-negative cervical cancer receiving considerably less attention. As a result, HPV-negative cervical cancer is poorly understood. Its etiology remains elusive mainly due to limitations in research methodology such as lack of defined markers and model systems. Moreover, false HPV negativity can arise from inaccurate diagnostic methods, which also hinders the progress of research on HPV-negative cervical cancer. Since HPV-negative cervical cancer is associated with worse clinical features, greater attention is required to understand HPV-negative carcinoma. In this review, we provide a summary of knowledge gaps and current limitations of HPV-negative cervical cancer research based on current clinical statistics. We also discuss future directions for understanding the pathogenesis of HPV-independent cervical cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2119-2125
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• 2013

Background: The aim of the study was to determine risk factors for cervical cancer for women in Izmir. Methods: This cross-sectional, descriptive field covered a population of 4319 women of reproductive age (15-49) (household registration in the Mukhtar's office-2007). A total of 1,637 women were included in the sample given a four-part questionnaire through face-to-face interview by visiting the women in their homes in order to determine socio-demographic factors, obstetric history, genital hygiene and the use of family planning methods. In addition, during the data collection process, the women were given group training in order to raise awareness of cervical cancer. The number and percentage distributions of the data were calculated. Results: While the average age of the women was $31.9{\pm}9.77$ (Min: 15.00-Max: 49.00), education level of 43.4% of them was elementary school only. It was determined that 70.3% of the women experienced at least one pregnancy, 71.0% had vaginal delivery and 75.9% used a contraceptive method. In the study it was determined that among the cervical cancer related risks vaginal delivery, vaginal lavage and having three or more pregnancies had the highest rates, while having sexual intercourse before 16 years of age and having more than one sexual partner constituted lower rates. The rate of the women who stated not having a smear in the last three years was 82.4%. Conclusions: Considering the case in terms of having Pap smear test, women's awareness on the risk factors and early diagnosis of cervical cancer was found to be low. Due to this reason, awareness of women has to be raised through education.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4457-4461
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• 2016

Purpose: To determine the prevalence of abnormal cervical cytology, as diagnosed using a liquid-based cytology technique, in pregnant women attending the Antenatal Care (ANC) clinic at Siriraj Hospital. Materials and Methods: This cross-sectional study included 655 first-visit pregnant women who attended ANC clinic at Siriraj Hospital during June to November 2015 study period. After receiving routine antenatal care, cervical cytology screening was performed with the Siriraj liquid-based cytology technique. All specimens were reviewed by a certified cytopathologist using Bethesda System 2001 criteria. Patients with abnormal PAP results characterized as epithelial cell abnormalities were referred to a gynecologic oncologist for further management according to ASCCP Guidelines 2012. Results: Mean age of participants was $28.9{\pm}6.2$ years. Prevalence of abnormal cervical cytology was 3.4% (95% CI: 2.0-4.7). Among this group, there were ASC-US, ASC-H, LSIL, HSIL for 12(1.8%), 2(0.3%), 7(1.1%) and 1(0.2%), respectively. In 633 specimens of the normal group, infection was identified in 158 specimens (24.1%) which were caused by Candida spp. and Trichomonas vaginalis. Regarding patient perception about the importance of cervical cancer screening, although most women perceived screening to be important, 54% of participants had never been screened for cervical cancer. Rate of loss to follow-up in the postpartum period was as high as 41.8%. Conclusions: Prevalence of abnormal cervical cytology in pregnant women attending the ANC clinic at Siriraj Hospital was 3.4%. Inclusion of cervical cancer screening as part of antenatal assessment can help to identify precancerous lesions or cervical cancers in patients who might otherwise not be screened, thereby facilitating early treatment and improved patient outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7977-7980
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• 2014

This study was undertaken to evaluate the prevalence of significant cervical pathology among women who are high-risk human papillomavirus (HR-HPV)-positive/cytology negative, the most common combination of positive co-tests. The records of 244 women HR-HPV-positive/cytology-negative who had undergone colposcopy at Srinagarind Hospital, Khon Kaen University during January 2010 and April 2014 were reviewed. Mean age was 46.4 years. Of these 224 women, 75 were positive for HPV types 16/18 (33.5%) and 123 were positive for non-16/18 types (54.9%). HR-HPV was not genotyped in the remaining 26 women (11.6%). Prevalence of significant lesions for the entire cohort was 2.4%, and 2.6% and 3.3%, respectively, for those with HPV 16/18 and other oncogenic HPV types. One woman with HPV 16/18 (1.3%) had invasive cervical cancer. Multiparous women were more likely to be infected with HPV 16/18 compared to nulliparous women (36.3% versus 17.6%, respectively). In conclusion, the prevalence of significant cervical lesion among our study population was 2.4%. Multiparous women were more likely to be infected with HPV 16/18 compared to nulliparous women.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2913-2921
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• 2012

Introduction: The impact of cervical cancer prevention programs depends on persuading women to go for screening and, if needed, treatment. As part of an evaluation of a pilot project in Indonesia, qualitative research was conducted to explore the factors that influence women's decisions regarding screening and treatment and to generate practical recommendations to increase service coverage and reduce loss to follow up. Methods: Research was conducted at 7 of the 17 public health centers in Karawang District that implemented the pilot project. Interviews and focus group discussions were held with 20 women, 20 husbands, 10 doctors, 18 midwives, 3 district health officials, and 16 advocacy team members. Results: Free services and mobile outreach events encouraged women to go for screening, along with promotional efforts by community health workers, advocacy teams, and the mass media. Knowledge and perceptions were the most important barriers to screening: women were not aware of cervical cancer risks, did not know the disease was treatable, and were fatalistic. Factors facilitating treatment were social support from husbands, relatives, and friends and the encouragement and role modeling of health workers. Barriers to prompt treatment included limited access to services and the requirement for husband's consent for cryotherapy. Conclusion: As cervical cancer prevention services are scaled up throughout Indonesia, the findings suggest three strategies to expand screening coverage and ensure prompt treatment: strengthening community mobilization and advocacy activities, modifying the service delivery model to encourage a single visit approach to screening and treatment, and working to gain men's support.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6151-6154
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• 2014

A growing body of literature is evidence that identifying subtypes of high-risk human papillomavirus (HR-HPV) has impacted on various steps of cervical cancer prevention.Thus, it is mandatory to determine the background prevalence and distribution of HPV subtypes for designing and implementing area-specific management. The present study was conducted to evaluate prevalence and distribution of HPV subtypes among women aged 30-70 years living in Lampang, an area with a high incidence of cervical cancer, through use of a mobile screening unit. Of 2,000 women recruited in this study, 108 (5.40%, 95%CI: 4.45-6.48) were found to have HR-HPV infection. Risk was significantly correlated with age and number of partners. Singly or in combination, the most common genotype was HPV 52 (17.6%), followed by HPV 16 (14.81%), HPV 58 (13.89%), HPV 33 (11.11%), HPV 51 (11.11%), and HPV 56 (9.26%). HPV 18 was found in only 5.6% of cases. Together, HPV 16/18 were noted in approximately 20.4% of cases. Eighteen(16.67%) women were positive with multiple subtypes of HR-HPV. Co-infection most frequently involved HPV 16 or HPV 58. These findings have obvious implications for vaccine policy.