• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8801-8807
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• 2014

Purpose: The aim of the study was to evaluate knowledge, attitudes and behaviors of Turkish women over 20 years old on cervix cancer. Materials and Methods: This descriptive study was performed at a primary care center covering 246 women using a questionnaire composed of 3 sections and 38 questions. The data were analyzed using descriptive statistics, chi-square test in univariate analysis and multivariate hierarchical logistic regression analysis. Results: Of the 93.7% women who knew about cervical cancer, 68.0% of them had heard pap smear test and 46.1% had actually undergone a Pap smear once or more throughout their lives. According to the results of the hierarchical logistic regression analysis about factors affecting the Pap smear test; in Model 1, increase in age and education levels, in Model 2 and Model 3 increase in age and cervical cancer information points were determined. The most important information source for cervical cancer was TV-radio/media (59.9%) and health care workers (62.8%) for pap smear test. Conclusions: Although most women have heard of cervical cancer, knowledge about cervical cancer and also Pap smear screening rate are significantly lower. Having Pap smear test for women was affected by age and knowledge level about cervical cancer. Informing women about cervical cancer would be an important intervention.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3159-3163
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• 2012

Background: For cervical cancer the epidemiological profile is poorly known in Morocco and no data is available concerning the direct medical costs. The purpose of this work is to estimate the direct cost of medical management of invasive cervical cancer during the first year after diagnosis in Morocco. Methods: The estimation of direct costs of medical management of invasive cervical cancer during the first year after diagnosis in Morocco is based on the estimation of individual cost in each stage which covers diagnosis, treatment and follow-up during first year. The cost was estimated per patient and whole cycle-set using the costs for each drug and procedure as indicated by the Moroccan National Agency for Health Insurance. Extrapolation of the results to the whole country was used to calculate the total annual cost of cervical cancer treatments in Morocco. Results: Overall approximately 1,978 new cases of cervical cancer occur each year in Morocco. The majority (82.96%) of these cases were diagnosed at a late stage (stageII or more). The cost of one case of cervical cancer depends on stage of diagnosis, the lowest cost is $382 for stageCis followed by the cost of stageIA1 for young women (< 40 years) which is $2,952. The highest cost is for stageIV, which is $7,827. The total cost of cervical cancer care for one year after diagnosis is estimated at $13,589,360. The share allocated to treatment is the most important part of the global care budget with an annual sum of $13,027,609 whereas other cost components are represented as follows: $435,694 for annual follow-up activity and $126,057 for diagnosis and preclinical staging. Conclusion: This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of health facilities in Morocco.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4903-4906
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• 2013

Background: The purpose of this study was to determine proportional rates of cervical precancerous lesions and cancer, and associations with socio-demographic variables, HIV status, and CD4 cell count. Materials and Methods: A retrospective comparative study was conducted targeting the medical records of all women over age 18 that were diagnosed histologically through colposcopy with cervical precancerous lesions and cancer from 1 December 2011 to 30 November 2012. Results: A total of 313 patient records were used for data analysis. The average age was 39.1 (SD=2.04) years. More than a third (37.1%) of the patients had CIN III or cervical cancer. There was a significant association between age, CD4 cell count, HIV status, and cervical lesions (p<0.05). Age was found to be an influential predictor of cervical lesions (OR=0.67, 95%CI: 0.46-0.98). Conclusions: There exists an association between age and cervical lesions, with presentation of cervical precancerous lesions and cervical cancer at a younger age among HIV reactive patients. The National Guidelines should be brought in line with the National HIV Counseling and Testing Policy to offer Pap smears to all sexually active women that test HIV reactive during routine HIV Testing.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4865-4869
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• 2013

Background: The objectives of this present study were to assess the awareness of cervical cancer and its risk factors among female undergraduates in South Africa, and to determine the their level of acceptability of Human Papillomavirus (HPV) vaccination. Materials and Methods: This cross-sectional study was conducted in March 2013 among 440 full time undergraduate female students. Results: Of those students who never had sex (n=163), 96 (58.9%) had ever heard of cervical cancer and only 12 students (12.5%) knew that HPV causes cervical cancer. More than a third (35.4%) of the students correctly said that sexual intercourse before age of 18 years is a risk factor for cervical cancer and 55.2% of the students knew about the Pap smear test which is used for screening cervical cancer. The majority (77.3%) were willing to accept HPV vaccination. Results revealed that students who knew about the Pap smear test, and were aware that having multiple sex partners, sexual intercourse before the age of 18 years, smoking and having contracted any STDs are risk factors for cervical cancer were more likely to accept HPV vaccination compared to other groups. Conclusions: The general knowledge of South African female university students about cervical cancer is not sufficient but they have positive attitudes toward getting vaccinated with the HPV vaccine.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2473-2476
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• 2014

Background: Little is known about the cancer screening prevalence and correlates in older adults from different racial backgrounds. In the context of heightened efforts for prevention and early diagnosis, we collected information on screening for two major types of cancers: cervical and breast cancer in order to establish their prevalence estimates and correlates among older South African women who participated in the Study of Global Ageing and Adults Health (SAGE) in 2008. Materials and Methods: We conducted a national population-based cross-sectional study with a multi-stage stratified cluster sample of 3,840 individuals aged 50 years or older in South Africa in 2008. In this analysis, we only considered the female subsample of (n=2202). The measures used included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables and cancer screening. Results: Overall, regarding cervical cancer screening, 24.3% ever had a Papanicolaou (PAP) smear test, and regarding breast cancer screening, 15.5% ever had a mammography. In multivariate logistic regression analysis, younger age, higher education, being from the White or Coloured population group, urban residence, greater wealth, and suffering from two or more chronic conditions were associated with cervical cancer screening, and higher education, being from the White or Indian/Asian population group, greater wealth, having a health insurance, and suffering from two or more chronic condtions were associated with breast cancer screening. Conclusions: Cancer screening coverage remains low among elderly women in South Africa in spite of the national guideline recommendations for regular screening in order to reduce the risk of dying from these cancers if not detected early. There is a need to improve accessibility and affordability of early cervical and breast cancer screening for all women to ensure effective prevention and management of cervical and breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1093-1096
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• 2012

Background: Cervical cancer is common among women worldwide. A multitude of risk factors aggravate the disease. This study was conducted to: (1) determine the prevalence and (2) make a comparative analysis of the socio-demographic and behavioural risk factors of cervical cancer and knowledge, attitude and practice between rural and urban women of North Bengal, India. Study Design: Community-based cross-sectional study. Methods: A survey (first in North Bengal) was conducted among 133 women in a rural area (Kawakhali) and 88 women in an urban slum (Shaktigarh) using predesigned semi-structured questionnaires. The respondents were informed of the causes (including HPV), signs and symptoms, prevention of cervical cancer and treatment, and the procedure of the PAP test and HPV vaccination. Results: The prevalence of risk factors like multiparity, early age of marriage, use of cloth during menstruation, use of condom and OCP, early age of first intercourse was 37.2%, 82%, 83.3%, 5.4%, 15.8% and 65.6% respectively. Awareness about the cause, signs and symptoms, prevention of cervical cancer, PAP test and HPV vaccination was 3.6%, 6.3%, 3.6%, 9.5% and 14.5% respectively. Chi-square testing revealed that in the study population, significant differential at 5% exists between rural and urban residents with respect to number of children, use of cloth/sanitary napkins, family history of cancer and awareness regarding causes of cervical cancer. Regarding KAP, again using chi-square tests, surprisingly, level of education is found to be significant for each element of KAP in urban areas in contrast to complete absence of association between education and elements of KAP in rural areas. Conclusions: A large number of risk factors were present in both areas, the prevalence being higher in the rural areas. The level of awareness and role of education appears to be insignificant determinants in rural compared to urban areas. This pilot study needs to be followed up by large scale programmes to re-orient awareness campaigns, especially in rural areas.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.11
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• pp.4477-4487
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• 2015

In this review we summarize the results of studies employing high-throughput methods of profiling of HPV-associated cervical intraepithelial neoplasia (CIN) and squamous cell cervical cancers at key intracellular regulatory levels to demonstrate the unique identity of the landscape of molecular changes underlying this oncopathology, and to show how these changes are related to the 'natural history' of cervical cancer progression and the formation of clinically significant properties of tumors. A step-wise character of cervical cancer progression is a morphologically well-described fact and, as evidenced by genome-wide screenings, it is indeed the consistent change of the molecular profiles of HPV-infected epithelial cells through which they progressively acquire the phenotypic hallmarks of cancerous cells. In this sense, CIN/cervical cancer is a unique model for studying the driving forces and mechanisms of carcinogenesis. Recent research has allowed definition of the whole-genome spectrum of both random and regular molecular alterations, as well as changes either common to processes of carcinogenesis or specific for cervical cancer. Despite the existence of questions that are still to be investigated, these findings are of great value for the future development of approaches for the diagnostics and treatment of cervical neoplasms.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4897-4902
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• 2013

Here we assessed the effectiveness of cervical cancer screening using data from the Hiroshima Prefecture Cancer Registry regarding patient age at the start of screening and differences in screening intervals. A screening model was created to calculate the health status in relation to prognosis following cervical cancer screening and its influence on life expectancy. Epidemiological data on the mortality rate of cervical cancer by age groups and mortality rates from the Hiroshima Prefecture Cancer Registry were used for the model projections. Our results showed that life expectancy when screening rate was 100% compared with 0% was extended by approximately 1 month. Furthermore, when the incidence of cervical cancer was 0% compared with the screening rate was 100%, life expectancy was extended by a maximum of 3 months. Moreover, among individuals affected by cervical c ancer, a difference of 13 years in life expectancy was calculated between screened and unscreened groups.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2193-2197
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• 2012

Background: Methylenetetrahydrofolate reductase (MTHFR) is a key enzyme in the metabolism of folate, and the role of MTHFR C677T polymorphism in cervical carcinogenesis is still controversial. Method: We performed a meta-analysis of all relevant case-control studies that examined any association between the C677T polymorphism and cervical cancer risk. We estimated summary odds ratios (ORs) with their confidence intervals (CIs) to assess links. Results: Finally, 10 studies with a total of 2113 cervical cancer cases and 2804 controls were included. Results from this meta-analysis showed that significantly elevated cervical cancer risk was associated with the MTHFR T allele in the Asian population under conditions of two genetic comparison models (for TT vs. CC, OR = 1.37, 95%CI 1.00-1.87, P = 0.050; for TT vs. TC+CC: OR = 1.34, 95%CI 1.01-1.77, P = 0.039). However, there was no obvious association between the MTHFR C677T polymorphism and cervical cancer risk in the other populations. Conclusion: The MTHFR C677T polymorphism is associated with cervical cancer risk in Asians, while any possible link in the Caucasian population needs further studies.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6391-6396
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• 2015

Background: To analyze cervical cancer mortality trends in China from 1991-2013 and forecast the mortality distribution in future five years (2014-2018), and provide clues for prevention and treatment. Materials and Methods: Mortality data for cervical cancer in China from 1991 to 2013 were used to describe the epidemiological characteristics and distribution, including the trend of the standardized mortality rate, urban-rural differences, and age variation. Trend-surface analysis was used to analyze the geographical distribution of mortality. Curve estimation, time series, gray modeling, and joinpoint regression were performed to predict and forecast mortality trends. Results: In recent years, the mortality rate of cervical cancer has increased, and there is also a steady increase in the incidence from 2003 to 2013 in China. Mortality rates in rural areas are higher than in urban areas. The mortality dramatically increases in the 40+ yr age group, reaching a peak in the >85 yr age group. In addition, geographical analysis showed that the cervical cancer mortality increased from the southwest to west-central and from the southeast to northeast of the country. Conclusions: The incidence rate and the mortality rate are increasing from 1991 to 2013, and the predictions show this will continue in the future. Thus, implementation of prevention and management programs for cervical cancer are necessary in China, especially for rural areas, young women in urban areas, and high risk regions (the west-central).