• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7595-7600
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• 2013

Cervical cancer is a serious public health problem in developing countries. We investigated possible risk factors for cervical cancer in rural areas of Wuhan China using a matched case-control study with 33 women diagnosed with cervical cancer and 132 healthy women selected from the same area as matched controls. A questionnaire, which included questions about general demography conditions, environmental and genetic factors, the first sexual intercourse, first marriage age, age at first pregnancy, pregnancy first child's age, female personal health history, social psychological factors, dietary habits, smoking and alcohol status and other living habits was presented to all participants. At the same time, HPV infection of every participant was examined in laboratory testing. Results showed HPV infection (P<0.000, OR=23.4) and pregnancy first child's age (P<0.000, OR=13.1) to be risk factors for cervical cancer. Menopause (P=0.003, OR=0.073) was a protective factor against cervical cancer. However, there was no indication of associations of environmental (drinking water, insecticide, disinfectant) genetic (cancer family history), or life-style factors (smoking status, alcohol status, physical training, sleep quality), including dietary habits (intake of fruit and vegetable, meat, fried food, bean products and pickled food) or social psychological factors with cervical cancer. The results suggest that the risk of cervical cancer in Chinese rural women may be associated with HPV infection, menopause and the pregnancy first child's age.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2643-2646
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• 2012

Objectives: Human papillomavirus (HPV) is the major etiological agent of cervical cancer, a leading cause of morbidity and mortality in women worldwide. Screening strategies for reducing the burden of HPV-mediated carcinogenesis are emerging as an effective means for cervical cancer control and prevention in developing countries. Our study, therefore, aimed to identify HPV infection status in North Indian women during random population screening. Methodology: Cervical/vaginal exfoliated cells and/or Pap smear specimens were collected from 890 women of North Indian ethnicity residing in Lucknow and adjoining areas, during random population screening from June 2009-March 2012. HPV viral loads in clinical specimens were determined by the Hybrid Capture (hc)-2 HPV DNA assay, and subsequently, positive/negative/borderline HPV status was calculated. Results: The HPV incidence in the present study was 11.7%. 751 out of a total of 890 women (84.4%) participating in our HPV screening program were HPV negative (HPV -), 104 (11.7%) tested positive (HPV +) while 35 (3.9%) showed borderline (HPV $^*$) infection status. Furthermore, in the HPV + subjects (N=104), 18 (17.3%) showed strong positivity. We observed that HPV positivity tends to increase with age in North Indian women; the higher the viral load with increasing age, higher is the susceptibility to HPV-mediated cervical cancer. Conclusions: HPV viral load/genotyping may help in identifying women at risk of developing cervical cancer. However, cost-effective HPV screening protocols with a wider population coverage are warranted so as to reduce the burden of cervical cancer in women worldwide in the vaccine-era.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8287-8293
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• 2014

Background: This study assessed human papillomavirus (HPV), cervical cancer, and HPV vaccine knowledge and awareness among women in two sub-populations in Nepal - Khokana, a traditional Newari village in the Lalitpur District about eight kilometers south of Kathmandu, and Sanphebagar, a village development committee within Achham District in rural Far-Western Nepal. Methods: Study participants were recruited during health camps conducted by Nepal Fertility Care Center, a Nepali non-governmental organization. Experienced staff administered a Nepali language survey instrument that included questions on socio-demographics, reproductive health and knowledge on HPV, cervical cancer, and the HPV vaccine. Results: Of the 749 participants, 387 (51.7%) were from Khokana and 362 (48.3%) were from Sanphebagar. Overall, 53.3% (n=372) of women were aware of cervical cancer with a significant difference between Khokana and Sanphebagar (63.3% vs 43.0%; p=0.001). Overall, 15.4% (n=107) of women had heard of HPV and 32% (n=34) of these women reported having heard of the HPV vaccine. If freely available, 77.5% of the women reported willingness to have their children vaccinated against HPV. Factors associated with cervical cancer awareness included knowledge of HPV (Khokana: Odds Ratio (OR)=24.5; (95% Confidence Interval (CI): 3.1-190.2, Sanphebagar: OR=14.8; 95% CI: 3.7-58.4)) and sexually transmitted infections (Khokana: OR=6.18; 95% CI: 3.1-12.4; Sanphebagar: OR=17.0; 95% CI: 7.3-39.7) among other risk factors. Conclusions: Knowledge and awareness of HPV, cervical cancer, and the HPV vaccine remains low among women in Khokana and Sanphebagar. Acceptance of a freely available HPV vaccine for children was high, indicating potentially high uptake rates in these communities.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3271-3274
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• 2012

Purpose : This study was performed to assess whether the weight status is associated with screening rates of breast and cervical cancer in Korean women. Methods: Study participants included women aged between 30 and 80 years from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Body mass index was classified into ${\sim}18.4kg/m^2$ (underweight), $18.5{\sim}22.9kg/m^2$ (normal), $23{\sim}24.9kg/m^2$ (overweight), $25.0{\sim}29.9kg/m^2$ (moderate obesity) and $30.0kg/m^2$~ (severe obesity) according to the Asia Pacific Standards of WHO recommended definition of obesity. Screening rates of breast and cervical cancer were estimated by the recommendation of the National Cancer Screening Program of the National Cancer Center, Korea. Results : The overall screening rates for breast and cervical cancer were 51.3% and 50.1%, respectively. After covariate adjustment, the screening rates for breast cancer (adjusted odds ratio, 0.70; 95% confidence interval, 0.51 to 0.97) and cervical cancer (adjusted odds ratio, 0.71; 95% confidence interval, 0.53 to 0.94) were significantly lower in the women with severe obesity. Conclusion: Obesity is associated with lower compliance with breast and cervical cancer screening guidelines in Korean women.

• Women's Health Nursing
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• v.10 no.2
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• pp.150-161
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• 2004

The importance of screening or repeat screening for cervical and breast cancer is well known to decrease the chance of death from cancer. Few data is avaliable regarding factors associated with participation in cervical and breast cancer screening and repeat screening examinations. This study was to investigate the associations of demographic factors, health status and cancer risk recognition, attitude to cancer screening, health behaviors, and inhibiting or facilitating factors to cervical and breast cancer screening with participation in the screening tests. Data was collected with self-administrated questionnaires from 342 women, aged 40 to 69 years. The cancer screenings were classified into have had or never groups and repeat or not repeated groups. In the case of cervical and breast cancer screening, the have had group was 90 (26.3%), and 82 (24.0%) and the repeat group was 17 (5.0%), and 13 (3.8%) respectively. According to logistic regression analysis, age (<60 vs ${\geq}60$ : OR=3.25, 95% CI=1.27-8.26), breast cancer screening (Do vs Don't : OR=14.49, 95% CI=7.46-27.78) and other person's cancer (Yes vs No : OR=4.27, 95% CI=1.01-18.05) were statistically significantly associated with participation in screening for cervical cancer. Regular exercise (Do vs Don't : OR=2.76, 95% CI=1.30-5.88) and cervical cancer screening (Do vs Don't : OR=13.70, 95% CI=7.09-26.32) were statistically significantly related to participation in screening for breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7401-7407
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• 2015

Cervical cancer continues to be a serious public health problem in the developing world, including China. Because of its large population with geographical and socioeconomic inequities, China has a high burden of cervical cancer and important disparities among different regions. In this review, we first present an overview of the cervical cancer incidence and mortality over time, and focus on diversity and disparity in access to care for various subpopulations across geographical regions and socioeconomic strata in China. Then, we describe population-based cervical cancer screening in China, and in particular implementation of the National Cervical Cancer Screening Program in Rural Areas (NACCSPRA) and the challenges that this program faces. These include low screening coverage, shortage of qualified health care personnel and limited funds. To improve prevention of cervical cancer and obtain better cancer outcomes, the Chinese government needs to urgently consider the following key factors: reducing disparities in health care access, collecting accurate and broadly representative data in cancer registries, expanding target population size and increasing allocation of government funding for training of personnel, improving health education for women, enhancing quality control of screening services and improving a system to increase follow up for women with positive results.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7951-7954
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• 2014

Background: To evaluate the cervical pathology of cytology-negative/high-risk human papillomavirus (HR-HPV) positive-women. Materials and Methods: This study recruited 4,583 women aged 30-70 years who had undergone cervical screening by liquid-based cytology and HR-HPV test (14 HR-HPV types) at Lampang Cancer Hospital during October 2012 to July 2013. Colposcopy was carried out in all women. Results: One hundred and ninety-two (4.19%) women were found to be cytology-negative/HR-HPV-positive. However, 23 cases were excluded because of incomplete information, leaving 169 women for further analyses. Of these 169, 45 (26.6%) were infected with HPV 16/18 and 49 (29.0%) with multiple genotypes of HR-HPV. Nineteen of 169 (11.24%) women were found to have CIN 2-3. No women in the present study had AIS or invasive cervical lesions. Prevalence of CIN 2-3 among women infected with HPV 16/18 was 15.6% which was higher than the 9.68% in those with non-HPV 16/18 oncogenic types. Conclusions: Overall, 11% of cytology-negative/HR-HPV-positive women had significant cervical lesions. Risk of harboring such lesions was substantially increased among those who were HPV 16/18 positive.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4567-4570
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• 2012

Objectives: The purposes of this study were to determine the prevalence and predictive value to detect significant neoplasia and invasive lesions, and to evaluate the correlation between clinical and histopathology of women with squamous cell carcinoma (SCCA) on Siriraj liquid-based cervical cytology (Siriraj-LBC). Methods: The computerized database of women who underwent Siriraj-LBC at Siriraj Hospital, Mahidol University from January 2007 to December 2010 were retrieved. The hospital records of women with SCCA cytology were reviewed. Results: The prevalence of SCCA cytology was 0.07%. A total of 86 women, mean age was 58.1 years. Sixty-one women (70.9%) were post-menopausal. Overall significant pathology and invasive gynecologic cancer were detected in 84 women (97.7%) and 71 women (82.5%), respectively. The positive predictive values for detection of significant neoplasia and invasive lesion were 97.7% and 82.6%, respectively. The cervical cancer was diagnosed in 69 women and among these 58 women were SCCA. Thirteen women (15.1%) had cervical intraepithelial neoplasia (CIN) 3 and two women (2.3%) had cervicitis. The sensitivity and specificity of colposcopy for cervical cancer detection in SCCA cytology were 83.3% and 75%, respectively. Median follow up period was 17.6 months and 64 patients were alive without cytologic abnormality. Conclusions: The final histopathology of SCCA cytology in our populations demonstrated a wide variety, from cervicitis to invasive cancer and the most common diagnosis was invasive cervical cancer. Colposcopy with biopsy and/or endocervical curettage and loop electrosurgical excision procedure should be undertaken to achieve histologic diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4959-4963
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• 2016

Objective:Cervical cancer is one of the major causes of mortality of Uyghur women in Xinjiang, China. Although increased expression of orexin receptor (OxR), known to be strongly expressed in human placenta, has a proven relation to some cancers, there have been few studies of cervical cancer. Thus, we explored this question by evaluating the expression of orexin receptor as a biomarker for screening early stage of cervical cancer in Uyghur women with highest occurrence rate of cervical cancer in China. Study Design: We used polymerase chain reaction (PCR) and immunohistochemical staining to determine the expression of both Ox1R and Ox2R in cervical cancer and cervicitis biopsies collected from Uyghur women infected with human papilloma virus (HPV)16. The expression rate was compared between cervical cancers of low, intermediate and high differentiation and cervicitis. Results:Although there was no significant difference in the expression rate of Ox1R between groups, Ox2R was significantly overexpressed in cervical cancer patients when compared to the cervicitis group. Ox1R was negative in normal human placenta while Ox2R was positive. Conclusions: While expression of Ox1R had no correlation with invasion or metastatic potential, Ox2R demonstrated elevation in cervical cancer with heterogeneity in groups with different metastatic potential, in the human placenta as well, implying that it might serve as an indicator of invasive capacity along with other indices.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9433-9437
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• 2014

This study provides the first systematic literature review of cervical cancer incidence and mortality as well as human papillomavirus (HPV) genotype prevalence among women with cervical cancer in the Pacific Island countries and territories. The cervical cancer burden in the Pacific Region is substantial, with age standardized incidence rates ranging from 8.2 to 50.7 and age standardized mortality rate from 2.7 to 23.9 per 100,000 women per year. The HPV genotype distribution suggests that 70-80% of these cancers could be preventable by the currently available bi- or quadrivalent HPV vaccines. There are only few comprehensive studies examining the epidemiology of cervical cancer in this region and no published data have hitherto described the current cervical cancer prevention initiatives in this region.