• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.589-594
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• 2013

Background: Prospective cohort studies to determine cofactors with oncogenic HPV-infections for cervical cancer are very rare from developing countries and such data are limited to the few screening trials. Large screening trials provide such data as a by product. Some of the cases are prevented by screening and do not surface as invasive cancers at all. Also, pre-invasive lesions are detected almost entirely by screening. Screening causes selection bias if attendance in or effectiveness of screening is correlated with the risk factors. The aim of this study was to quantify the influence of screening on risk factors for cervical cancer. Materials and Methods: Our material stems from a rural cohort of 80,000 women subjected to a randomised screening trial. The effect of screening on the incidence of cervix cancer was estimated with reference to socio-demographic and reproductive risk factors of cervical cancer. We compared these risks with the incidence of cancer in the randomised control population by the same determinants of risk. Results: The results in the screening arm compared to the control arm showed that the women of low SES and young age were benefitting more than those of high SES and old age. The relative risk by age (30-39 vs 50-59) was 0.33 in the control arm and 0.24 in the screening arm. The relative risk by education (not educated vs educated) was 2.8 in the control arm and 1.8 in the screening arm. The previously married women did not benefit (incidence 113 and 115 per 100,000 women years in control vs screening arms) whereas the effect was substantial in those married (86 vs 54). Conclusions: The results in controls were consistent with the general evidence, but results in attenders and nonattenders of the screening arm showed that screening itself and self-selection in attendance and effectiveness can influence the effect estimates of risk factors. The effect of cervical cancer screening programmes on the estimates of incidence of cervical cancer causes bias in the studies on etiology and, therefore, they should be interpreted with caution.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.4867-4871
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• 2012

Cervical cancer is a leading cause of morbidity and mortality in women worldwide. Although the human papillomavirus (HPV) is considered the major causative agent of cervical cancer, yet the viral infection alone is not sufficient for cancer progression. The etiopathogenesis of cervical cancer is indeed complex; a precise understanding of the complex cellular/molecular mechanisms underlying the initiation, progression and/or prevention of the uterine cervix is therefore essential. Autophagy is emerging as an important biological mechanism in targeting human cancers, including cervical cancer. Furthermore, autophagy, a process of cytoplasm and cellular organelle degradation in lysosomes, has been implicated in homeostasis. Autophagic flux may vary depending on the cell/tissue type, thereby altering cell fate under stress conditions leading to cell survival and/or cell death. Autophagy may in turn govern tumor metastasis and subsequent carcinogenesis. Inflammation is a known hallmark of cancer. Vascular insufficiency in tumors, including cervical tissue, leads to depletion of glucose and/or oxygen perturbing the osmotic mileu causing extracellular acidosis in the tumor microenvironment that may eventually result in autophagy. Thus, targeted manipulation of complex autophagic signaling may prove to be an innovative strategy in identification of clinically relevant biomarkers in cervical cancer in the near future.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1289-1293
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• 2015

Background: Anal intraepithelial lesions (AIL) are likely to represent a precursor for anal cancer. Women infected with human immunodeficiency virus (HIV) may be at higher risk of anal cancer but a screening program for AIL still is not routinely recommended. We here studied the relationship of dysplastic cells from cervical and anal cytology in HIV-infected women. Materials and Methods: This prospective study was conducted in Prapokklao Hospital, Thailand during 2013-2014. Five hundred and ninety nine HIV-infected women were recruited. Participants who had cytological reports of equally or over "abnormal squamous/glandular cells of undetermined significance" (ASC-US) were classified as abnormal cervical or anal cytology. Descriptive statistics and logistic regression analysis were used to evaluate correlations between groups. Results: HIV-infected women with abnormal cervical cytology had 3.8 times more risk (adjusted odd ratio 3.846, 95% confidence interval 1.247-11.862, p-value. 019) for abnormal anal cytology. The major problem of the anal Pap test in this study was the inadequacy of the collected specimens for evaluation (34.4%, 206/599). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of cervical and anal Pap tests were 93.9/12.0, 87.3/96.9, 39.7/21.4, 99.4/94.1 and 88.1/91.4 percent, respectively. Conclusions: Abnormal cervical cytology in HIV-infected women indicates elevated risk for abnormal anal cytology. The sensitivity of the anal Pap test for detection of AIL 2/3 in HIV-infected women was quite low while specificity was excellent. Inadequacy of specimen collection for evaluation was a major limitation. Improvement of sample collection is recommended for future investigations.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5517-5522
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• 2014

Oral contraceptive use is the most common type of contraception. More than 300 million women worldwide take oral contraceptives every day. However, there is a concern about the relationship with the incidence of cancer. This analytical retrospective study aimed to investigate the relationship between the incidence of cervical and breast cancers and oral contraceptive use in 128 Iranian patients with cervical cancer, 235 with breast cancer and equal numbers of controls. Data were collected through interviews with an organized set of questions. Details were also extracted from patient files. Data were analyzed using Student's t-test, chi-square and Fisher's exact tests, and Pearson's correlation analysis. The result revealed correlations between both cervical and breast cancers and history of contraceptive pills use. While cervical cancer significantly correlated with duration of use of pills, breast cancer had significant correlations with the type of oral contraceptive and age at first use. No significant relationships were found between the two types of cancer and age at discontinuation of oral contraceptives, patterns of use, and intervals from the last use. The use of oral contraceptives may triple the incidence of cervical cancer and doubles the incidence of breast cancer. Therefore, performing Pap smears every six months and breast cancer screening are warranted for long-term oral contraceptive users.

• 여성건강간호학회지
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• 제19권1호
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• pp.13-22
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• 2013

Purpose: This study was conducted to evaluate Korean version of the beliefs about Papanicolau (Pap) test and cervical cancer [CPC-28] in unmarried university students. Methods: The Korean version of CPC-28 (K-CPC-28) was developed through forward-backward translation techniques. A reliability, confirmatory factor analysis and correlations coefficients were evaluated. Data were collected from 303 unmarried female students attending university using a questionnaire that included28 items of CPC, 5 items of susceptibility of cervicalcancer and 8 items of HPV knowledge. Results: K-CPC-28 had reliable internal consistency with Cronbach's ${\alpha}$=.74 of six subscales ranged from .66 to .80. Factor loadings of the 28 items of subscales ranged from .31 to .86. Six factors in this study explained 55% of the total variance. In convergent validity of the K-CPC-28, the subscales of K-CPC-28 were significantly correlated with susceptibility scale of cervical cancer and HPV knowledge scale. Conclusion: K-CPC-28has satisfactory construct validity and reliability. It seems to be an acceptable tool to assess the attitudes toward cervical cancer prevention and Pap smear in unmarried women. This tool would be also applicable to screen the risk group in cervical cancer prevention and to identify its association with actual Pap test or cervical cancer prevention behaviors.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2147-2150
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• 2013

Gynecological malignancies account for 9% of all female cancers worldwide. In the Arab countries Breast cancer is the leading cancer in women followed by cervical cancer. Ovarian cancer ranks as fourth leading cancer in women. There are huge differences in the available resources among Arab countries. However the challenges facing the provision of gynecological cancers services shared similarities like the cultural and religious background. Most of the gynecological cancers are diagnosed at a later stage in Arab countries due to the lack of reproductive health awareness especially among older women combined with the cultural stigma of seeking medical advice for gynecological symptoms. This article discusses the current situation of gynecological cancer services in Arab countries and suggests some practical solutions.

• 한국융합학회논문지
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• 제12권5호
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• pp.365-372
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• 2021

본 연구는 유방암과 자궁경부암을 진단받은 성인 여성의 삶의 질과 영향요인을 확인하기 위하여 시행되었다. 국민건강영양조사 제7기 원시자료를 활용한 이차분석연구로, 유방암을 진단받은 성인 여성 130명과 자궁경부암을 진단받은 성인 여성 98명을 대상으로 하였다. 자료는 IBM SPSS 26.0 프로그램을 이용하여 가중치를 적용한 복합표본분석 방법으로 분석하였다. 그 결과, 유방암과 자궁경부암을 진단받은 성인 여성은 연령이 낮을수록, 가구소득과 주관적 건강상태가 높으면 삶의 질 수준이 높았다. 유방암과 자궁경부암을 진단받은 성인 여성의 주관적 건강상태를 증진하는 중재 전략과 연령이 높고 가구소득이 낮은 대상자의 삶의 질을 개선하는 중재 전략이 필요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2965-2972
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• 2016

Background: China carries a heavy burden of cervical cancer (CC) and substantial disparities exist across regions within the country. In order to reduce regional disparities in CC, the government of China launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Critical to the success of the program are the health care workers who play a pivotal role in preventing and managing CC by encouraging and motivating women to use screening services and by providing identification and treatment services. This study aimed to assess cervical cancer knowledge among these health care workers at the county level in maternal and child health (MCH) hospitals across different socio-economic regions of China. Materials and Methods: A cross-sectional survey was conducted and self-administered questionnaires were sent to all health care workers (a total of 66) providing cervical cancer screening services in 6 county level MCH hospitals in Liaoning, Hubei and Shaanxi provinces, representing eastern, central and western regions of China; 64 (97.0%, 64/66) of the workers responded. ANOVA and Chi-square test were used to compare the knowledge rate and scores in subgroups. Results: The knowledge level of the respondents was generally low. The overall combined knowledge rate was 46.9%. The knowledge rates for risk factors, prevention, clinical symptoms, screening and diagnostic tests and understanding of positive results were 31.3%, 37.5%, 18.1%, 56.3% and 84.4%, respectively. Statistically significant differences in scores or rates of CC knowledge were seen across the different regions. The total and sectional scores in the less developed regions were statistically significantly lower than in the other regions. Conclusions: The majority of the health care workers who provide CC screening service in NCCSPRA at county level MCH hospitals do not have adequately equipped with knowledge about CC. Given the importance of knowledge to the program's success in reducing CC burden in rural women in China, efforts are needed to improve the knowledge of health care workers, especially in less developed regions.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7483-7487
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• 2013

Purpose: Human papillomavirus (HPV) infection plays an important role in the development of cervical cancer, but the prevalence of HPV infection in women of Shenzhen city remains unclear. The present study was performed to describe the change of cervical HPV infection in females who participated in voluntary cervical cancer screening from 2006 to 2010 in Shenzhen city, China. Methods: A total of 4, 413 women were recruited. HPV infections were genotyped by polymerase chain reaction (PCR) and reversed dot blot hybridization in Shenzhen Maternity and Child Health Hospital. Results: The prevalence of HPV infection was 13.8%. The five most commonly found HPV types were HPV16 (3.47%), HPV58 (1.68%), HPV33 (1.38%), HPV43 (1.36%) and HPV18 (1.27%). The secular trends of major HPV type-specific were diverse. Among of them, the prevalence of HPV18 increased sharply while others increased slowly or even decreased in the period. The change of total HPV, single HPV and multiple HPV infection were similar during the five years. Conclusions: Our findings suggested that HPV infection is common with HPV16 and HPV 58 as the primary subtypes in women in Shenzhen city.The prevalence of HPV 18 infection is increasing faster than any others, which will lead it to be one of the main subtypes in this city in the future.

• 보건행정학회지
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• 제9권1호
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• pp.139-155
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• 1999

This study was performed to assess the practice behavior and the need for cancer screening in order to design the community projects in Suwon city. A random sample of urban married women was surveyed on knowledge, attitude, and practice of breast and cervical cancer screening by telephone from April 28th to May 19th. Four hundred two married women completed the questionnaire, and the results were as follows: 1. Urban women were not generally knowledgeable about symptoms, signs and etiology of breast and cervical cancer. Only 11.4% of respondents were fully aware of those subjects. 2. Two hundred eighty six repondents(71.1%) reported having had a mammogram or Pap smear, while 116 respondents(28.9%) reported never having had a mammogram nor Pap smear. 3. The rate of mammogram increased by age and income status significantly(p〈0.05). 4. The majority(73.1%) of women who had a mammogram reported that it was part of a routine physical examination and another 24.3% of the women reported that they had a mammogram for specific breast problems. Meanwhile, the reasons reported for never having a mammogram were as follows; never had any problems (72.1%), no chance(11.2%), no time(4.3%). 5. The main factors associated with adherence to mammography screening guidelines was monthly income status. 6. The majority(80.6%) of women who had a Pap smear reported that it was part of a routine physical examination and another 16.0% of the women reported that it was part of a routine physical examination and another 16.0% of the women reported that they had a Pap smear for specific uterus problems. Meanwhile, the reasons reported for never having a Pap smear were: never had any problems(69.0%) and no chance(11.5%) 7. Women with higher income status were most likely to have a Pap smear regularly (p〈0.01), and the rate of Pap smear increased by education level significantly(p〈0.05). The main factors associated with adherence to Pap smear screening guidelines were education level and monthly income status, similar to those of mammograph. These findings indicate that married women in Suwon city show a lower rate of breast and cervical cancer screening practice than that of developed countries. The rate of mammograph was especially low. It is, therefore, suggested that cost, environmental factors, process, and information for screening tests be considered more programmatically before designing a community project for breast and cervical cancer screening.