• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3147-3153
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• 2016

Background: Many strategies are required for cervical cancer reduction e.g. provision of education cautious sexual behavior, HPV vaccination, and early detection of pre-invasive cervical lesions and invasive cancer. Basic health data for cervical cytology/ HPV DNA and associated factors are important to make an appropriate policy to fight against cervical cancer. Aims: To assess the prevalence of abnormal cervical cytology and/or HPV DNA and associated factors, including sexual behavior, among Bangkok Metropolitan women. Materials and Methods: Thai women, aged 25-to-65 years old, had lived in Bangkok for ${\geq}5$ years were invited into the study. Liquid-based cervical cytology and HPV DNA tests were performed. Personal data were collected. Main Outcomes Measures: Rates of abnormal cytology and/ or high-risk HPV (HR-HPV) and factors associated with abnormal test (s) were studied. Results: Abnormal cytology and positive HR-HPV were found in 6.3% (279/4442 women) and 6.7% (295/4428), respectively. The most common abnormal cytology was ASC-US (3.5%) while the most common HR-HPV genotype was HPV 16 (1.4%) followed by HPV 52 (1.0%), HPV 58 (0.9%), and HPV 18 and HPV 51 at equal frequency (0.7%). Both tests were abnormal in 1.6% (71/4428 women). Rates of HR-HPV detection were directly associated with severity of abnormal cytology: 5.4% among normal cytology and 13.0%, 30.8%, 40.0%, 39.5%, 56.3% and 100.0% among ASC-US, ASC-H, AGC-NOS, LSIL, HSIL, and SCC, respectively. Some 5% of women who had no HR-HPV had abnormal cytology, in which 0.3% had ${\geq}$ HSIL. Factors associated with abnormal cytology or HR-HPV were: age ${\leq}40$ years, education lower than (for cytology) or higher than bachelor for HR-HPV), history of sexual intercourse, and sexual partners ${\geq}2$. Conclusions: Rates for abnormal cytology and HR-HPV detection were 6.3% and 6.7% HR-HPV detection was directly associated with severity of abnormal cytology. Significant associated factors were age ${\leq}40$ years, lower education, history of sexual intercourse, and sexual partners ${\geq}2$.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3663-3673
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• 2016

Cervical cancer (CaCx) is the second most fatal cancer contributing to 14% of cancers in Indian females, which account for 25.4% and 26.5% of the global burden of CaCx prevalence and mortality, respectively. Persistent infection with high-risk human papilloma virus (HPV- strains 16 and 18) is the most important risk factor for precursors of invasive CaCx. Comprehensive prevention strategies for CaCx should include screening and HPV vaccination. Three screening modalities for CaCx are cytology, visual inspection with acetic acid, and HPV testing. There is no Indian national policy on CaCx prevention, and screening of asymptomatic females against CaCx is practically non-existent. HPV vaccines can make a major breakthrough in the control of CaCx in India which has high disease load and no organized screening program. Despite the Indian Government's effort to introduce HPV vaccination in the National Immunization Program and bring down vaccine cost, challenges to implementing vaccination in India are strong such as: inadequate epidemiological evidence for disease prioritization, duration of vaccine use, parental attitudes, and vaccine acceptance. This paper reviews the current epidemiology of CaCx and HPV in India, and the current status of HPV vaccination in the country. This article stresses the need for more research in the Indian context, to evaluate interventions for CaCx and assess their applicability, success, scalability and sustainability within the constraints of the Indian health care system.

• BMB Reports
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• 제55권9호
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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.

• 한국융합학회논문지
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• 제13권1호
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• pp.119-129
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• 2022

자궁경부세포검사는 자궁경부암 선별검사로 널리 사용되어 왔다. 그러나, 위음성 비율이 높아 인유두종바이러스 중합효소연쇄반응 (HPV PCR) 검사로 보완이 제안되고 있다. HPV PCR 검사의 임상적 유용성을 확인하여, 자궁경부암을 예방하는 선별검사의 효과를 알아보고자 한다. 217명의 환자의 데이터를 분석하였고, 높은 HPV 감염률(46.1%)과 분산분석결과 연령 집단간 HPV 감염률에 유의한 차이가 보였다(P=0.015). 특히, 연구기간 중 CIN3 3건 상피세포암 1건이 관찰되었는데, 고위험군 HPV(16, 33)감염이 모두 관찰되었고, 20대와 30대 상피세포 이형성증 진단 환자에서 높은 고위험군 HPV감염이 관찰되었다. 따라서 이 연령대에 대한 광범위한 연구 및 예방 활동이 필요하며, 자궁암 예방을 위한 선별검사로써 세포학적 검사와 함께 HPV PCR 검사가 유용할 것으로 판단된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권6호
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• pp.327-336
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• 2016

Cervical cancer is the second most prevalent cancer among women, and it arises from cells that originate in the cervix uteri. Among several causes of cervical malignancies, infection with some types of human papilloma virus (HPV) is well known to be the greatest cervical cancer risk factor. Over 150 subtypes of HPV have been identified; more than 40 types of HPVs are typically transmitted through sexual contact and infect the anogenital region and oral cavity. The recently introduced vaccine for HPV infection is effective against certain subtypes of HPV that are associated with cervical cancer, genital warts, and some less common cancers, including oropharyngeal cancer. Two HPV vaccines, quadrivalent and bivalent types that use virus-like particles (VLPs), are currently used in the medical commercial market. While the value of HPV vaccination for oral cancer prevention is still controversial, some evidence supports the possibility that HPV vaccination may be effective in reducing the incidence of oral cancer. This paper reviews HPV-related pathogenesis in cancer, covering HPV structure and classification, trends in worldwide applications of HPV vaccines, effectiveness and complications of HPV vaccination, and the relationship of HPV with oral cancer prevalence.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4409-4413
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• 2016

Background: Cervical cancer is the second most common of malignancy found in Thai women. Human papillomavirus (HPV) infection is a major cause. The objective of the present study was to evaluate the prevalence of HPV infection and association with abnormal cervical cytology in Thai women. Materials and Methods: This study was conducted at the Gynecologic Clinic, Thammasat University, Pathum Thani, Thailand. A total of 2,144 cases who underwent annual cervical cancer screening by co-testing (liquid based cytology and HPV testing, DNA versus mRNA) during the priod from July 2013 to June 2016 were recruited in this study. Results: Prevalence of positive high risk (HR) HPV DNA and mRNA test were 19.7 and 8.4%, respectively with a statistically significant difference. Majority of cases of abnormal cytology in this study were atypical squamous cells of undetermined significance (ASC-US). In patients with ASC-US, positive HR HPV DNA was greater than in the mRNA group (10.1 and 4.5%, p<0.001). Nonetheless, there was no significant difference in participants with cervical intraepithelial neoplasia (CIN). HPV mRNA test had slightly lower sensitivity but higher negative predictive value (NPV) than the DNA test to detect abnormal cytology during cervical cancer screening (p<0.001). Both HPV test (DNA and mRNA) had equally efficacy to detect high grade precancerous lesion or higher (CIN 2+). Conclusions: Prevalence of HR HPV DNA and mRNA were 19.7 and 8.4 percent, respectively. NPV of HPV mRNA was higher than DNA test. Both tests had equal efficacy to detect CIN 2+ with sensitivity and specificity of 63% vs 55.7% and 83% vs 92%, respectively.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3637-3641
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• 2016

To determine the prevalence of human papillomavirus (HPV) among women with atypical squamous cells of undetermined significance (ASC-US) referred to colposcopy and the implications for clinical management in low- and middle-income countries (LMIC), the present study was conducted. We included 200 women living in $Maring{\acute{a}}$/Brazil referred to colposcopy service between August 2012 and March 2013 due to an abnormal cytology from ASC-US until high-grade intraepithelial lesion (HSIL). HPV was detected and genotyped by polymerase chain reaction (PCR). The mean age was $36.8{\pm}10.5$ years, and women with and without ASC-US had similar mean ages ($37.4{\pm}11.5$ and $36.4{\pm}9.96$ years, respectively). The highest prevalence of ASC-US occurred at 20-24 years (40%). HPV-DNA was positive in 164 (82.0%) women.Of the 57 women with ASC-US, 30 (52.6%) were HPV-DNA-positive and 21 (70%) were high-risk HPV-positive (HR-HPV); the latter was similar to women without ASC-US (76.9%) but with other abnormal cytological findings present. Our data demonstrated that performing tests for HR-HPV can be used for management of women with ASC-US to support the decision of which women should be referred for an immediate or later colposcopy. The same conclusions can be applied to other LMICs for which HPV testing for primary screening has not been adopted.

• 보건교육건강증진학회지
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• 제27권1호
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• pp.1-8
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• 2010

Objectives: Human papillomavirus (HPV) infection is highly associated with cervical cancer. So, the modification of the risk factors of HPV infection is essential for prevention of cervical cancer. This study was performed to evaluate the risk factors of HPV infection. Methods: HPV test of 12,337 study population conducted using Hybrid-Capture II assay(HC-II) and self-administered questionnaires were collected. The study population was people who visited hospital-based medical screening center from January to December 2007 and all were female employees or employees' partner. Results: In logistic regression analysis, smoking and alcohol drinking were significant factors, with odds ratios of 1.328 (95% CI 1.010~1.746) and 1.644 (95% CI 1.309~2.066), respectively. Nutritional supplements was also significant factor, which odds ratio was 1.161 (95% CI 1.004~1.343). Oral contraceptives was positive association with HPV infection (odds ratio 2.108; 95% CI 1.217~3.652), whereas condom was negative association (odds ratio 0.851; 95% CI 0.740~0.979). Conclusion: HPV Prevalence of 12,377 study population was 11.4%. Smoking, alcohol drinking, nutritional supplements and oral contraceptives were possible risk factors of HPV infection, and condom had possible preventive effect on HPV infection. Further prospective and comprehensive studies about HPV risk factors are required.

• 대한의생명과학회지
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• 제25권4호
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• pp.390-397
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• 2019

High risk-human papillomavirus (HR-HPV) is known to be a major cause of cervical cancer, and coinfection of sexually transmitted pathogen (STP) has been reported to cause persistent HPV infection. However, the relationship between HPV and STP coinfection remains unclear. The purpose of this study was to analyze the coinfection rate with STP in high-risk human papillomavirus infected women in Busan and to collect basic data for the prevention of cervical lesions. This study was carried out in 355 women who had concurrent HPV and STP screening at Busan local hospital between January 2016 and December 2017. HPV and STP coinfection was found in 187 (52.7%) out of 355 cases. HR-HPV and STP coinfection was 82.9% higher than LR-HPV and STP coinfections 17.1%. In HR-HPV infection, Ureaplasma species was the most common pathogen (47.1%), followed by C. trachomatis (21.9%) and Mycoplasma species (12.3%). In the analysis of HR-HPV genotype according to STP, HPV 16 (12.0%) was the most frequent, followed by HPV 58 (11.6%), HPV 39 (11.1%) and HPV 52 (10.2%), but HPV 18 showed a low coinfection rate of 1.3%. According to the results of age, HR-HPV and STP coinfection rate was the highest at 41.9% among women aged 18 to 29. HR-HPV and Ureaplasma species showed the highest coinfection rates at all ages, followed by C. trachomatis and Mycoplasma species. Further studies with more samples will be needed to determine if the coinfection of HR-HPV and STPs is involved in the development of cervical tumors through histologic changes.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4353-4356
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• 2016

Purpose: To study the prevalence of CIN2+ diagnosis in women with atypical Papaniculoau (Pap) smears to suggest appropriate management option for Thai health care. Materials and Methods: Data from all patients with liquid based cytology with human papillomavirus (HPV) testing between May 2013 - May 2016 were collected from medical records. Women with atypical cervical Pap smears were recruited. Results for age, HPV testing, HPV 16, 18, 45 and other genotypes tested, colposcopic examination and histopathological assessment were all collected. Atypical smears were defined as atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells cannot be exclude high grade squamous intraepithelial lesion (ASC-H). Results: A total of 2,144 cases were recruited. Twenty six women with ASC-US on cytology had high risk (HR) HPV detection while eight cases with ASC-H had HR-HPV (40.0% VS 72.7%, p=0.005). Among the 26 women with ASC-US cytology and positive HR-HPV, HPV type 16 (n=8, 30.8%), type 18 (n=1, 3.8%), type 45 (n=1, 3.8%) and other HPV types (n=17, 65.4%) were found. Eight women with ASC-H and positive HR-HPV demonstrated type 16 (n=6, 75%) and other HPV types (n=2, 25%). Fifty seven women with ASC-US had normal colposcopy, CIN1 and CIN2+ at percentages of 80.7 (46/57), 14.0 (8/57) and 5.3 (3/57), respectively. In the ASC-H group, 7 out of 10 women had normal colposcopy and three (30%) had CIN2+ results. Conclusions: In women with ASC-US cytology, immediate colposcopy is highly recommended. HPV testing can be performed if colposcopy is not an available option because there was high prevalence (5.3%) of CIN2+ in our findings. ASCCP recommendations for ASC-H that colposcopy should be performed on all ASC-H cases regardless of HPV result are thereby supported by the findings of this investigation.