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Clinical Microbiology Reviews Jan 2003Of the many types of human papillomavirus (HPV), more than 30 infect the genital tract. The association between certain oncogenic (high-risk) strains of HPV and cervical... (Review)
Review
Of the many types of human papillomavirus (HPV), more than 30 infect the genital tract. The association between certain oncogenic (high-risk) strains of HPV and cervical cancer is well established. Although HPV is essential to the transformation of cervical epithelial cells, it is not sufficient, and a variety of cofactors and molecular events influence whether cervical cancer will develop. Early detection and treatment of precancerous lesions can prevent progression to cervical cancer. Identification of precancerous lesions has been primarily by cytologic screening of cervical cells. Cellular abnormalities, however, may be missed or may not be sufficiently distinct, and a portion of patients with borderline or mildly dyskaryotic cytomorphology will have higher-grade disease identified by subsequent colposcopy and biopsy. Sensitive and specific molecular techniques that detect HPV DNA and distinguish high-risk HPV types from low-risk HPV types have been introduced as an adjunct to cytology. Earlier detection of high-risk HPV types may improve triage, treatment, and follow-up in infected patients. Currently, the clearest role for HPV DNA testing is to improve diagnostic accuracy and limit unnecessary colposcopy in patients with borderline or mildly abnormal cytologic test results.
Topics: DNA, Viral; Female; Humans; Papillomaviridae; Uterine Cervical Neoplasms
PubMed: 12525422
DOI: 10.1128/CMR.16.1.1-17.2003 -
Sexual Medicine Reviews Jan 2020Cervical cancer is the leading cause of cancer deaths in women in the developing world. New technologies have been developed to allow for more rapid, cost-effective, and... (Review)
Review
INTRODUCTION
Cervical cancer is the leading cause of cancer deaths in women in the developing world. New technologies have been developed to allow for more rapid, cost-effective, and sensitive cervical cancer screening and treatment.
AIM
The aim of this study was to describe methods for detection and treatment of human papillomavirus (HPV), cervical dysplasia (CD), and cervical cancer. New technologies and updated screening strategies will be emphasized.
METHODS
A literature search was conducted using PubMed to identify publications relevant to the subject.
MAIN OUTCOME MEASURE
Sensitivity and cost-effectiveness of new cervical cancer screening methods were the main outcome measures.
RESULTS
HPV and cervical cancer have a significant global impact. Research and innovations related to detection and treatment are key in reducing their burden worldwide.
CONCLUSION
Screening a woman for HPV and CD can dramatically decrease her risk of dying from cervical cancer. New, rapid, low-cost, HPV testing can allow for high-volume screening for the approximately 1.5 billion women who have never been screened. HPV screening can then be combined with high resolution digital colposcopy to detect CD. In the near future, these colposcopic images will be interpreted by artificial intelligence software. Detected lesions can then be treated easily and effectively with thermocoagulation. This see-and-treat model is a sensitive, efficient, and low-cost vision for the future. Bedell SL, Goldstein LS, Goldstein AR, et al. Cervical Cancer Screening: Past, Present, and Future. Sex Med Rev 2020;8:28-37.
Topics: Early Detection of Cancer; Female; Forecasting; Humans; Papillomaviridae; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms
PubMed: 31791846
DOI: 10.1016/j.sxmr.2019.09.005 -
Journal of B.U.ON. : Official Journal... 2016Purpose: Despite the widespread screening programs, cervical cancer remains the third most common cancer in developing countries. Based on the implementation of cervical... (Review)
Review
Purpose: Despite the widespread screening programs, cervical cancer remains the third most common cancer in developing countries. Based on the implementation of cervical screening programs with the referred adoption of improved screening methods in cervical cytology with the knowledge of the important role of the human papilloma virus (HPV) it's incidence is decreased in the developed world. Even if cervical HPV infection is incredibly common, cervical cancer is relatively rare. Depending on the rarity of invasive disease and the improvement of detection of pre-cancerous lesions due to the participation in screening programs, the goal of screening is to detect the cervical lesions early in order to be treated before cancer is developed. In populations with many preventive screening programs, a decrease in cervical cancer mortality of 50-75% is mentioned over the past 50 years. The preventive examination of vagina and cervix smear, Pap test, and the HPV DNA test are remarkable diagnostic tools according to the American Cancer Association guidelines, in the investigation of asymptomatic women and in the follow up of women after the treatment of pre-invasive cervical cancer. The treatment of cervical cancer is based on the FIGO 2009 cervical cancer staging.
Topics: Age Factors; Aged; DNA, Viral; Early Detection of Cancer; Female; Human Papillomavirus DNA Tests; Humans; Middle Aged; Neoplasm Staging; Papanicolaou Test; Papillomaviridae; Predictive Value of Tests; Reproducibility of Results; Risk Factors; Uterine Cervical Neoplasms; Vaginal Smears; Uterine Cervical Dysplasia
PubMed: 27273940
DOI: No ID Found -
Cells Jun 2019Cervical cancer develops through persistent infection with high-risk human papilloma virus (hrHPV) and is a leading cause of death among women worldwide and in the... (Review)
Review
Cervical cancer develops through persistent infection with high-risk human papilloma virus (hrHPV) and is a leading cause of death among women worldwide and in the United States. Periodic surveillance through hrHPV and Pap smear-based testing has remarkably reduced cervical cancer incidence worldwide and in the USA. However, considerable discordance in the occurrence and outcome of cervical cancer in various populations exists. Lack of adequate health insurance appears to act as a major socioeconomic burden for obtaining cervical cancer preventive screening in a timely manner, which results in disparate cervical cancer incidence. On the other hand, cervical cancer is aggressive and often detected in advanced stages, including African American and Hispanic/Latina women. In this context, our knowledge of the underlying molecular mechanism and genetic basis behind the disparate cervical cancer outcome is limited. In this review, we shed light on our current understanding and knowledge of racially disparate outcomes in cervical cancer.
Topics: Epigenesis, Genetic; Female; Healthcare Disparities; Humans; Models, Biological; Papillomaviridae; Risk Factors; Uterine Cervical Neoplasms
PubMed: 31234354
DOI: 10.3390/cells8060622 -
Cancer Medicine Oct 2018Cervical cancer is the third most common cancer in women worldwide, with concepts and knowledge about its prevention and treatment evolving rapidly. Human papillomavirus... (Review)
Review
Cervical cancer is the third most common cancer in women worldwide, with concepts and knowledge about its prevention and treatment evolving rapidly. Human papillomavirus (HPV) has been identified as a major factor that leads to cervical cancer, although HPV infection alone cannot cause the disease. In fact, HPV-driven cancer is a small probability event because most infections are transient and could be cleared spontaneously by host immune system. With persistent HPV infection, decades are required for progression to cervical cancer. Therefore, this long time window provides golden opportunity for clinical intervention, and the fundament here is to elucidate the carcinogenic pattern and applicable targets during HPV-host interaction. In this review, we discuss the key factors that contribute to the persistence of HPV and cervical carcinogenesis, emerging new concepts and technologies for cancer interventions, and more urgently, how these concepts and technologies might lead to clinical precision medicine which could provide prediction, prevention, and early treatment for patients.
Topics: Early Detection of Cancer; Female; Humans; Mass Screening; Papillomaviridae; Papillomavirus Infections; Precision Medicine; Uterine Cervical Neoplasms
PubMed: 30589505
DOI: 10.1002/cam4.1501 -
Cancer Letters Jan 2021Cervical cancer is one of the foremost common cancers in women. Human papillomavirus (HPV) infection remains a major risk factor of cervical cancer. In addition,... (Review)
Review
Cervical cancer is one of the foremost common cancers in women. Human papillomavirus (HPV) infection remains a major risk factor of cervical cancer. In addition, numerous other genetic and epigenetic factors also are involved in the underlying pathogenesis of cervical cancer. Recently, it has been reported that apolipoprotein B mRNA editing enzyme catalytic polypeptide like (APOBEC), DNA-editing protein plays an important role in the molecular pathogenesis of cancer. Particularly, the APOBEC3 family was shown to induce tumor mutations by aberrant DNA editing mechanism. In general, APOBEC3 enzymes play a pivotal role in the deamination of cytidine to uridine in DNA and RNA to control diverse biological processes such as regulation of protein expression, innate immunity, and embryonic development. Innate antiviral activity of the APOBEC3 family members restrict retroviruses, endogenous retro-element, and DNA viruses including the HPV that is the leading risk factor for cervical cancer. This review briefly describes the pathogenesis of cervical cancer and discusses in detail the recent findings on the role of APOBEC in the molecular pathogenesis of cervical cancer.
Topics: APOBEC Deaminases; Animals; Female; Humans; Immunity, Innate; Uterine Cervical Neoplasms
PubMed: 33038491
DOI: 10.1016/j.canlet.2020.10.004 -
Asian Pacific Journal of Cancer... Feb 2018Introduction: Cervical cancer rates vary across the world, being highest in Eastern Africa (including Zimbabwe) and lowest in Western Asia. It is the second most common... (Review)
Review
Introduction: Cervical cancer rates vary across the world, being highest in Eastern Africa (including Zimbabwe) and lowest in Western Asia. It is the second most common type of cancer in women in the South East Asia region and a major cause of cancer deaths among women of low and middle income countries (LMICs) like Nepal. This review is an attempt to make a comprehensive report of prevalence, incidence and mortality of cervical cancer in LMICs. Methods: The review was conducted applying a computerized search with the Medical Subject Heading (MeSH) major topics “Cervical Cancer”, “Cervical neoplasm” “Epidemiology”, (“prevalence” OR “incidence” OR “mortality”) and “HPV” OR “Human papillomavirus” as MeSH subheading. The search limits were: language (“English”), LMICs, dates (articles published from “1st January 2000 to 31st December 2015”), and species (“Humans”). The search was supplemented by cross-referencing. Publications that met the inclusion criteria were included in the synthesis. Results: Among the 20 studies reviewed; seven were from Africa, seven from Asia, three from South America, and one each from North America, Europe and Oceania. The review found the highest reported age standardized incidence rate as 17.9/100,000/year in Zimbabwe in 2000 and the lowest as 0.11/100,000/year in China in 2006. One study of Nigeria revealed a cervical cancer prevalence of 5.0 per 1,000 in 2012 in the 25-64 year age group. Further, the highest reported age standardized mortality rate was 16/100,000/year in India in 2015 and the lowest 1.8/100,000/year in Colombia in 2013. In addition, coitarche, tobacco smoking, number of sexual partners and family history of cervical cancer were reported as significant risk factors. Conclusion: The study provides a review of reported prevalence, incidence and mortality of cervical cancer in LMICs from 1st January 2000 to 31st December 2015. The scarcity of information reveals a substantial need for further studies on cervical cancer prevalence, incidence and mortality with associated risk factors in LMICs.
Topics: Developing Countries; Female; Humans; Incidence; Income; Prevalence; Prognosis; Survival Rate; Uterine Cervical Neoplasms
PubMed: 29479954
DOI: 10.22034/APJCP.2018.19.2.319 -
International Journal of Gynecological... Mar 2022Cervical cancer represents a significant portion of the global cancer burden for women, with low- and middle-income countries carrying the bulk of this burden.... (Review)
Review
Cervical cancer represents a significant portion of the global cancer burden for women, with low- and middle-income countries carrying the bulk of this burden. Additionally, underserved populations in countries with sufficient resources may have a higher incidence of cervical cancer and poorer outcomes. Concurrent chemoradiotherapy is the standard-of-care treatment for locally advanced cervical cancer, which includes patients with stage IB3 to IVA disease, and it is effective for many patients; however, cervical cancer-related mortality remains high. The critical nature of cervical cancer treatment is underscored by the recent launch of the World Health Organization global initiative to accelerate the elimination of cervical cancer using a triple-intervention strategy of increased vaccination, screening, and treatment. The initiative calls for 90% of all patients diagnosed with cervical cancer to receive the appropriate treatment, but to reach this global goal there are significant barriers related to radiotherapy that must be addressed. We discuss and review evidence of the lack of adherence to guideline-recommended treatment, brachytherapy underutilization, limited access to radiotherapy in low- and middle-income countries, as well as regional limitations within high-income countries, as the major barriers to radiotherapy treatment for locally advanced cervical cancer. We further review ways these barriers are currently being addressed and, in some cases, make additional recommendations to address these issues. Finally, despite receiving recommended treatments, many patients with locally advanced cervical cancer have a poor prognosis. With effective administration of current standards of care, the global community will be able to shift focus to advancing treatment efficacy for these patients. We review several types of therapies under clinical investigation that are additions to concurrent chemoradiotherapy, including immune checkpoint inhibitors, antiangiogenic agents, DNA repair inhibitors, human papillomavirus vaccines, and radiosensitizing nanoparticles.
Topics: Brachytherapy; Cervix Uteri; Chemoradiotherapy; Female; Humans; Papillomavirus Vaccines; Uterine Cervical Neoplasms
PubMed: 35256434
DOI: 10.1136/ijgc-2021-003001 -
Cells Nov 2021Cervical cancer is one of the most prevalent gynaecological malignancies worldwide and is related to human papillomavirus (HPV) infection, viral persistence,... (Review)
Review
Cervical cancer is one of the most prevalent gynaecological malignancies worldwide and is related to human papillomavirus (HPV) infection, viral persistence, progression, and invasion. Therefore, the immune response is linked to HPV status. Natural killer (NK) cells play a central role against virus-infected cells and tumours through a delicate balance between activating and inhibitory receptors and secretion of cytokines and chemokines. These cells also play a crucial role in tumour immunosurveillance. For these reasons, there is growing interest in harnessing NK cells as an immunotherapy for cervical cancer. These studies are diverse and include many strategies such as transferring activated autologous or allogeneic NK cells, improving the activation and cytolytic activity of NK cells using cytokines or analogues and modifying chimeric antigen receptors to increase specificity and targeting NK cells. However, research regarding the application of NK cells in immunotherapy is limited. This article focuses on recent discoveries about using NK cells to prevent and treat cervical cancer and the possibility of cellular immunotherapy becoming one of the best strategies to exploit the immune system to fight tumours.
Topics: Female; Humans; Immune Evasion; Immunotherapy; Killer Cells, Natural; Models, Biological; Uterine Cervical Neoplasms
PubMed: 34831327
DOI: 10.3390/cells10113104 -
Systematic Reviews May 2013The systematic review on which this paper is based provided evidence for the Canadian Task Force on Preventive Health Care to update their guideline regarding screening... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The systematic review on which this paper is based provided evidence for the Canadian Task Force on Preventive Health Care to update their guideline regarding screening for cervical cancer. In this article we highlight three questions covered in the full review that pertain to the effectiveness of screening for reducing cervical cancer mortality and incidence as well as optimal timing and frequency of screening.
METHODS
We searched MEDLINE, Embase and Cochrane Central from 1995 to 2012 for relevant randomized controlled trials and observational studies with comparison groups. Eligible studies included women aged 15 to 70 years who were screened using conventional cytology, liquid-based cytology or human papillomavirus DNA tests. Relevance screening, data extraction, risk of bias analyses and quality assessments were performed in duplicate. We conducted a meta-analysis using a random-effects model on the one body of evidence that could be pooled.
RESULTS
From the 15,145 screened citations, 27 papers (24 studies) were included; five older studies located in a United States Preventive Services Task Force review were also included. A randomized controlled trial in India showed even a single lifetime screening test significantly decreased the risk of mortality from and incidence of advanced cervical cancer compared to no screening (mortality: risk ratio 0.65, 95% confidence interval 0.47, 0.90; incidence: relative risk 0.56, 95% confidence interval 0.42, 0.75). Cytology screening was shown to be beneficial in a cohort study that found testing significantly reduced the risk of being diagnosed with invasive cervical cancer compared to no screening (risk ratio 0.38; 95% confidence interval 0.23, 0.63). Pooled evidence from a dozen case-control studies also indicated a significant protective effect of cytology screening (odds ratio 0.35; 95% confidence interval 0.30, 0.41). This review found no conclusive evidence for establishing optimal ages to start and stop cervical screening, or to determine how often to screen; however the available data suggests substantial protective effects for screening women 30 years and older and for intervals of up to five years.
CONCLUSIONS
The available evidence supports the conclusion that cervical screening does offer protective benefits and is associated with a reduction in the incidence of invasive cervical cancer and cervical cancer mortality.
Topics: DNA, Viral; Female; Humans; Mass Screening; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 23706117
DOI: 10.1186/2046-4053-2-35