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cervical cancer low resource settings

Nicole G Campos, Monisha Sharma, Andrew Clark, Jane J Kim, Stephen C Resch
BACKGROUND: Cervical cancer is the fourth leading cause of cancer death in women, with 85% of cases and deaths occurring in developing countries. While organized screening programs have reduced cervical cancer incidence in high-income countries through detection and treatment of precancerous lesions, the implementation of organized screening has not been effective in low-resource settings due to lack of infrastructure and limited budgets. Our objective was to estimate the cost of comprehensive primary and secondary cervical cancer prevention in low- and middle-income countries...
2016: PloS One
Tara J Wu, Karen Smith-McCune, Miriam Reuschenbach, Magnus von Knebel Doeberitz, May Maloba, Megan J Huchko
OBJECTIVE: A biomarker with increased specificity for cervical dysplasia compared with human papillomavirus (HPV) testing would be an attractive option for cervical cancer screening among HIV-infected women in resource-limited settings. p16(INK4a) has been explored as a biomarker for screening in general populations. DESIGN: A 2-year cross-sectional study. SETTING: 2 large HIV primary care clinics in western Kenya. PARTICIPANTS: 1054 HIV-infected women in western Kenya undergoing cervical cancer screening as part of routine HIV care from October 2010 to November 2012...
September 13, 2016: BMJ Open
Sunny S Shah, Satyajyoti Senapati, Flora Klacsmann, Daniel L Miller, Jeff J Johnson, Hsueh-Chia Chang, M Sharon Stack
Mucosal infection by the human papillomavirus (HPV) is responsible for a growing number of malignancies, predominantly represented by cervical cancer and oropharyngeal squamous cell carcinoma. Because of the prevalence of the virus, persistence of infection, and long latency period, novel and low-cost methods are needed for effective population level screening and monitoring. We review established methods for screening of cervical and oral cancer as well as commercially-available techniques for detection of HPV DNA...
September 9, 2016: Cancers
Thomas C Randall, Rahel Ghebre
Virtually all cases of invasive cervical cancer are associated with infection by high-risk strains of human papilloma virus. Effective primary and secondary prevention programs, as well as effective treatment for early-stage invasive cancer have dramatically reduced the burden of cervical cancer in high-income countries; 85% of the mortality from cervical cancer now occurs in low- and middle-income countries. This article provides an overview of challenges to cervical cancer care in sub-Saharan Africa (SSA) and identifies areas for programmatic development to meet the global development goal to reduce cancer-related mortality...
2016: Frontiers in Oncology
Nicolas Çuburu, John T Schiller
Persistent human papillomavirus (HPV) is the primary etiologic agent of cervical cancer and causes a significant number of vulvar, penile, anal and oropharyngeal cancers. The development of highly effective HPV therapeutic vaccines is a reasonable goal given the recent advances in basic and applied immunology. A number of vaccine strategies designed to induce systemic T cell responses have been tested in clinical trials against high grade cervical or vulvar high grade neoplasia and cancers, but with limited success...
July 7, 2016: Human Vaccines & Immunotherapeutics
Yu-Ligh Liou, Tao-Lan Zhang, Tian Yan, Ching-Tung Yeh, Ya-Nan Kang, Lanqin Cao, Nayiyuan Wu, Chi-Feng Chang, Huei-Jen Wang, Carolyn Yen, Tang-Yuan Chu, Yi Zhang, Yu Zhang, Honghao Zhou
BACKGROUND: Opportunistic screening in hospitals is widely used to effectively reduce the incidence rate of cervical cancer in China and other developing countries. This study aimed to identify clinical risk factor algorithms that combine gynecologic examination and molecular testing (paired box gene 1 (PAX1) or zinc finger protein 582 (ZNF582) methylation or HPV16/18) results to improve diagnostic accuracy. METHODS: The delta Cp of methylated PAX1 and ZNF582 was obtained via quantitative methylation-specific PCR in a training set (57 CIN2- and 43 cervical intraepithelial neoplasia ≥grade 3 (CIN3+) women), and the individual and combination gene sensitivities and specificities were determined...
2016: Clinical Epigenetics
Serebe Abay, Adamu Addissie, Gail Davey, Bobbie Farsides, Thomas Addissie
BACKGROUND: Informed consent is a key component of bio-medical research involving human participants. However, obtaining informed consent is challenging in low literacy and resource limited settings. Rapid Ethical Assessment (REA) can be used to contextualize and simplify consent information within a given study community. The current study aimed to explore the effects of social, cultural, and religious factors during informed consent process on a proposed HPV-serotype prevalence study...
2016: PloS One
Curtis W Peterson, Donny Rose, Jonah Mink, David Levitz
In many developing nations, cervical cancer screening is done by visual inspection with acetic acid (VIA). Monitoring and evaluation (M&E) of such screening programs is challenging. An enhanced visual assessment (EVA) system was developed to augment VIA procedures in low-resource settings. The EVA System consists of a mobile colposcope built around a smartphone, and an online image portal for storing and annotating images. A smartphone app is used to control the mobile colposcope, and upload pictures to the image portal...
2016: Diagnostics
Nancy Jain, Ajay Halder, Ragini Mehrotra
Low uptake of cervical cancer screening is not a matter of poor coverage of health care facilities only. We wish to identify the perceived reasons behind low uptake of screening in Bhopal region and also possible solutions for an urban setting. In a mixed research, through a series of focused group discussions, we wished to do thematic interpretation of the perceptions towards cervical cancer screening by deductive content analysis of FGD and also to obtain a free list of perceived causes and solutions with Smith's saliency score and perform cluster analysis by pile sorting...
2016: Scientifica
Adriana T Lorenzi, José Humberto T Fregnani, Júlio César Possati-Resende, Márcio Antoniazzi, Cristovam Scapulatempo-Neto, Stina Syrjänen, Luisa L Villa, Adhemar Longatto-Filho
BACKGROUND: Human papillomavirus (HPV) DNA testing can be crucial for women who have limited access to traditional screening. The current study compared the results obtained through HPV DNA testing with those obtained through cytology-based screening. METHODS: A total of 3068 women aged 18 to 85 years were enrolled in an opportunistic cervical cancer screening program developed by the Barretos Cancer Hospital and performed by a team of health professionals working within a mobile unit from March to December 2012, followed by statistical analyses...
August 2016: Cancer Cytopathology
Christine Campbell, Savel Kafwafwa, Hilary Brown, Graeme Walker, Belito Madetsa, Miriam Deeny, Beatrice Kabota, David Morton, Reynier Ter Haar, Liz Grant, Heather A Cubie
The incidence of cervical cancer in Malawi is the highest in the world and projected to increase in the absence of interventions. Although government policy supports screening using visual inspection with acetic acid (VIA), screening provision is limited due to lack of infrastructure, trained personnel, and the cost and availability of gas for cryotherapy. Recently, thermo-coagulation has been acknowledged as a safe and acceptable procedure suitable for low-resource settings. We introduced thermo-coagulation for treatment of VIA-positive lesions as an alternative to cryotherapy within a cervical screening service based on VIA, coupled with appropriate, sustainable pathways of care for women with high-grade lesions and cancers...
August 15, 2016: International Journal of Cancer. Journal International du Cancer
Neo M Tapela, Tharcisse Mpunga, Bethany Hedt-Gauthier, Molly Moore, Egide Mpanumusingo, Mary Jue Xu, Ignace Nzayisenga, Vedaste Hategekimana, Denis Gilbert Umuhizi, Lydia E Pace, Jean Bosco Bigirimana, JingJing Wang, Caitlin Driscoll, Frank R Uwizeye, Peter C Drobac, Gedeon Ngoga, Cyprien Shyirambere, Clemence Muhayimana, Leslie Lehmann, Lawrence N Shulman
BACKGROUND: Cancer services are inaccessible in many low-income countries, and few published examples describe oncology programs within the public sector. In 2011, the Rwanda Ministry of Health (RMOH) established Butaro Cancer Center of Excellence (BCCOE) to expand cancer services nationally. In hopes of informing cancer care delivery in similar settings, we describe program-level experience implementing BCCOE, patient characteristics, and challenges encountered. METHODS: Butaro Cancer Center of Excellence was founded on diverse partnerships that emphasize capacity building...
2016: BMC Cancer
Rubina Shaikh, Vasumathi G Prabitha, Tapas Kumar Dora, Supriya Chopra, Amita Maheshwari, Kedar Deodhar, Bharat Rekhi, Nita Sukumar, C Murali Krishna, Narayanan Subhash
Optical spectroscopic techniques show improved diagnostic accuracy for non-invasive detection of cervical cancers. In this study, sensitivity and specificity of two in vivo modalities, i.e diffuse reflectance spectroscopy (DRS) and Raman spectroscopy (RS), were compared by utilizing spectra recorded from the same sites (67 tumor (T), 22 normal cervix (C), and 57 normal vagina (V)). Data was analysed using principal component - linear discriminant analysis (PC-LDA), and validated using leave-one-out-cross-validation (LOOCV)...
March 1, 2016: Journal of Biophotonics
Lynne Hampson, Innocent O Maranga, Millicent S Masinde, Anthony W Oliver, Gavin Batman, Xiaotong He, Minaxi Desai, Parmenas M Okemwa, Helen Stringfellow, Pierre Martin-Hirsch, Alex M Mwaniki, Peter Gichangi, Ian N Hampson
BACKGROUND: Cervical cancer is the most common female malignancy in the developing nations and the third most common cancer in women globally. An effective, inexpensive and self-applied topical treatment would be an ideal solution for treatment of screen-detected, pre-invasive cervical disease in low resource settings. METHODS: Between 01/03/2013 and 01/08/2013, women attending Kenyatta National Hospital's Family Planning and Gynaecology Outpatients clinics were tested for HIV, HPV (Cervista®) and liquid based cervical cytology (LBC-ThinPrep®)...
2016: PloS One
Natalia M Rodriguez, Winnie S Wong, Lena Liu, Rajan Dewar, Catherine M Klapperich
Paper diagnostics have successfully been employed to detect the presence of antigens or small molecules in clinical samples through immunoassays; however, the detection of many disease targets relies on the much higher sensitivity and specificity achieved via nucleic acid amplification tests (NAAT). The steps involved in NAAT have recently begun to be explored in paper matrices, and our group, among others, has reported on paper-based extraction, amplification, and detection of DNA and RNA targets. Here, we integrate these paper-based NAAT steps into a single paperfluidic chip in a modular, foldable system that allows for fully integrated fluidic handling from sample to result...
February 21, 2016: Lab on a Chip
Srabani Mittal, Ranajit Mandal, Dipanwita Banerjee, Pradip Das, Ishita Ghosh, Chinmay Panda, Jaydip Biswas, Partha Basu
PURPOSE: A demonstration project was conducted to assess feasibility of implementing HPV detection-based cervical cancer screening in primary care settings in India and to generate local evidence on feasibility and effectiveness of HPV detection in primary screening. METHODS: The project was implemented by setting up screening clinics at primary health centers. Eligible women were screened by HPV DNA test (Hybrid capture 2). All samples were processed and tested in a single laboratory...
March 2016: Cancer Causes & Control: CCC
Rosa Catarino, Patrick Petignat, Gabriel Dongui, Pierre Vassilakos
Cervical cancer (CC) represents the fourth most common malignancy affecting women all over the world and is the second most common in developing areas. In these areas, the burden from disease remains important because of the difficulty in implementing cytology-based screening programmes. The main obstacles inherent to these countries are poverty and a lack of healthcare infrastructures and trained practitioners. With the availability of new technologies, researchers have attempted to find new strategies that are adapted to low- and middle-income countries (LMIC) to promote early diagnosis of cervical pathology...
December 10, 2015: World Journal of Clinical Oncology
Jean Damascène Makuza, Sabin Nsanzimana, Marie Aimee Muhimpundu, Lydia Eleanor Pace, Joseph Ntaganira, David James Riedel
INTRODUCTION: Cervical cancer prevalence in Rwanda has not been well-described. Visual inspection with acetic acid or Lugol solution has been shown to be effective for cervical cancer screening in low resource settings. The aim of the study is to understand the prevalence and risk factors for cervical cancer and pre- cancerous lesions among Rwandan women between 30 and 50 old undergoing screening. METHODS: This cross-sectional analytical study was done in 3 districts of Rwanda from October 2010 to June 2013...
2015: Pan African Medical Journal
Sharmila Pimple, Gauravi Mishra, Surendra Shastri
PURPOSE OF REVIEW: Cervical cancer still remains the fourth most common cancer, affecting women worldwide with large geographic variations in cervical cancer incidence and mortality rates. There exist vast disparities in cervix cancer control and prevention efforts globally. The present review addresses the current developments in cervical cancer prevention and control across both high-income countries and low-middle income countries and attempts to identify new strategies that might help address the gaps in cervical cancer care disparities globally...
February 2016: Current Opinion in Obstetrics & Gynecology
M M Caster, A H Norris, C Butao, P Carr Reese, E Chemey, J Phuka, A N Turner
Cervical cancer is a common and deadly disease, especially in developing countries. We developed and implemented an interactive, tablet-based educational intervention to improve cervical cancer knowledge among women in rural Malawi. Chichewa-speaking adult women in six rural villages participated. Each woman took a pretest, participated in the lesson, and then took a posttest. The lesson included information on cervical cancer symptoms, causes, risk factors, prevention, and treatment. Over the 6-month study period, 243 women participated...
December 5, 2015: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
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