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Smoking and cervical cancer - Current status: A review
Abstract
This paper focuses on 15 epidemiological studies of cervical cancer and smoking and reviews important studies of multiple primary cancers which bear on the biologic plausibility of an association between cervical cancer and smoking. 4 of the 15 epidemiologic studies do not provide substantial evidence to refute the hypothesis that smoking and cervical cancer are associated. Of the 11 epidemiologic studies showing an association 9 were designed to test the smoking-cervical cancer hypothesis. Additional studies have examined the question of biologic plausibility and have provided substantial supporting evidence. The possibility that the association is due to confounding by an unknown factor has been investigated and found to be quite improbable. Therefore the evidence would seem to support the conclusion that the association between cigarette smoking and cervical cancer is causal and that a chemical carcinogen contained in tobacco smoke is responsible for a substantial proportion of the incidence of this disease. However this conclusion does not depreciate the importance of the established association between numbers of sexual partners and risk of cervical cancer interpreted as evidence for an infectious etiologic agent. Future epidemiologic study on cervical cancer should include appropriate biochemical and virologic components in the investigations.
... Almost 80 % of all the study subjects adopted unhygienic practices during menstrual cycle. [16][17][18][19] Distribution of study subjects by their history of sexually transmitted infections(STI) was seen by persistant vaginal discharge, smell, colour of discharge, pain during intercourse, pru ritis vulvae and inflammation of external genitalia. More than 50% of the study population had persistent vaginal discharge. ...
... Human Papilloma virus (HPV) is associated with almost all cervical cancer worldwide[Bosch et al. 1995;Schiffman 1995; Pisani et al.[14] 1997]. 5 Infection with on e or more of the oncogenic HPV types may result in the integration of the viral genome into the host cellular genome resulting in the formation of cervical neoplastic cells, the proliferation of which leads to various grades of CIN, which may progress to invasive cervical cancer [Shankarnarayan and Ramani 2003;[19] WHO, 2002; Ibne-Sina 1927;6 Ho 1995; Munoz, 1992;Thomas 2001;Walboomers 1999]. ...
To study the epidemiological characteristics of cervical cancer in Delhi. With this background we intended to find out the epidemiological characteristics associated with cervical cancer and screening of participants by pap smear.
Pap smear were conducted and detail socio demographic records were obtained and details of demographic characteristic and other risk factors were noted.
A total of 98 participants were evaluated of which 76.5% of women were in the age group of 30-40 years, By educational status about 46.94% were illiterate. Forty seven percent of the study subjects had a history of abortion. More than half of the study subjects (60.5%) had history of induced abortion in non-licensed clinics (70%). More than half of the study subjects (62%) were sexually active before 15 years of age and almost all the study subjects were sexually active by 18 years of age. Almost one third of the subjects did not Two third of the subjects (72%) among those using contraceptives used IUD and Tubal ligation use any contraceptive method. Thirty eight percent of the study subjects had normal cervix on per speculum examination and 40 % had cervical erosion.8.2% participants tested positive to pap smear.
... In addition, some studies have shown that vitamin A and beta carotene protect against cervical intraepithelial neoplasia. 112 Cigarette smokers have decreased serum beta carotene levels. Most likely, cigarette smoke acts as a cofactor facilitating HPV infection and as an immune suppressant. ...
... 120 As discussed previously, cigarette smoking is associated with an increase in the percentage of CD4 + in blood in seronegative populations. Several studies 112,114,116,117,121,122 have shown that these effects are attenuated in the HIV-infected smoking population during the first 2 years of infection. Analysis of the data suggested that an effect of smoking is present within the first few years of HIV infection but then disappears, and these patients ex-perience a marked decrease in CD4 + counts. ...
Abstract:
Herpes Simplex Virus type-1 (HSV-1) is classified in the α-herpes virus group of the Herpesviridae and HSV-1 infections are very common in the human population. The objective of this study is to determine the prevalence of anti-herpes simplex virus type-1 IgM and anti-herpes simplex virus type-1 IgG among smokers and nonsmokers. In the current study, A total of one hundred two serum samples from males were collected (70 smokers and 32 nonsmokers), there ages were ranged between 20- 50 year; this study which was done during the period between September 2014 to the January 2015. All obtained sera samples from all persons were tested using ELISA method for determine of Herpes simplex virus type-1 antibodies. Results in this study showed that the herpes simplex virus type-1 IgM seropositivity among smoker persons was 24 (34.3%). In addition, the result revealed that the percentage rate of the herpes simplex virus type-1 IgG among smokers was 61(87.1%). There was a significant effect of smoking on the seroprevalence of Herpes simplex virus type-1 antibodies (IgM , IgG).
Key words: Herpes simplex virus type 1 (HSV-1), Seroprevalence, Smoking and Kirkuk.
... Conversely, delaying the age of sexual debut and reducing family size might reduce the risk of cervical cancer [15]. Evidence has shown that resources received from income transfer programmes, irrespective of conditionalities, are not particularly spent on alcohol or tobacco [6], both risk factors for breast and cervical cancer, respectively [16,17]. ...
Background
Socioeconomic conditions are strongly associated with breast and cervical cancer incidence and mortality patterns; therefore, social protection programmes (SPPs) might impact these cancers. This study aimed to evaluate the effect of SPPs on breast and cervical cancer outcomes and their risk/protective factors.
Methods
Five databases were searched for articles that assessed participation in PPS and the incidence, survival, mortality (primary outcomes), screening, staging at diagnosis and risk/protective factors (secondary outcomes) for these cancers. Only peer-reviewed quantitative studies of women receiving SPPs compared to eligible women not receiving benefits were included. Independent reviewers selected articles, assessed eligibility, extracted data, and assessed the risk of bias. A harvest plot represents the included studies and shows the direction of effect, sample size and risk of bias.
Findings
Of 17,080 documents retrieved, 43 studies were included in the review. No studies evaluated the primary outcomes. They all examined the relationship between SPPs and screening, as well as risk and protective factors. The harvest plot showed that in lower risk of bias studies, participants of SPPs had lower weight and fertility, were older at sexual debut, and breastfed their infants for longer.
Interpretation
No studies have yet assessed the effect of SPPs on breast and cervical cancer incidence, survival, or mortality; nevertheless, the existing evidence suggests positive impacts on risk and protective factors.
... In addition, this finding that SHS causes different diseases such as lower respiratory illnesses in infancy and early childhood (Fergusson et al. 1980;Al-Delaimy et al. 2002;Services 2006), middle ear disease and adenotonsillectomy (Jones et al. 2012), cervical, breast, and lung cancer in nonsmokers (Winkelstein Jr 1990;Zhong et al. 2000;Terry et al. 2011) is vital not only from a public health perspective but also in the social and economic issues and active efforts by medical professionals and politicians to reduce exposure of the nonsmoking community to SHS. More actions are required to control the dangerous effects of passive smoking, particularly in women and infants, and public health actions should prioritize reducing levels of passive smoking at home. ...
Secondhand smoke (SHS: a mixture of sidestream and mainstream smoke) and thirdhand smoke (THS: made up of the pollutants that settle indoors after smoking in closed environments) are a significant public health concern. SHS and THS contain various chemicals which can be released into the air or settle on surfaces. At present, the hazards of SHS and THS are not as well documented. In this review, we describe the chemical contents of THS and SHS, exposure routes, vulnerable groups, health effects, and protective strategies. The literature search was conducted for published papers on September 2022 in Scopus, Web of Science, PubMed, and Google Scholar databases. This review could provide a comprehensive understanding of the chemical contents of THS and SHS, exposure routes, vulnerable groups, health effects, protective strategies, and future researches on environmental tobacco smoke.
... A further study has proposed a model according to which the incidence rate of cervical cancer is proportional to the square of time since first intercourse [15]. Some factors, such as smoking, have been identified as co-factors, meaning that it increases the cervical cancer risk among HPV positive women [16]. In order to reveal these statistical associations, studies typically use uni-or bivariate tests [17]. ...
The purpose of this study is to uncover cervical cancer (CC) risk phenotypes from self-reported lifestyle questionnaires and screening data. In general, computational phenotype discovery aims to find subgroups among individuals that share distinctive characteristics by analyzing electronic health records (EHR). This can benefit the understanding of a disease as well as uncover risk factors and provide possibilities for preventive action. The features in the women ( $$n = 6359$$ n = 6359 ) by questionnaire features ( $$p=29$$ p = 29 ) matrix with missing data are of different statistical data types (e.g., binary or ordinal data). We use so-called generalized low-rank models (GLRM) that can address this challenge via different statistical-data-type-dependent loss functions. We show that these models can uncover phenotypes related to cervical cancer risk factors from large-scale questionnaire data.
... Only 4 (1.97%) of the subjects indicated they had a history of tobacco use, with all 4 (1.97%) negative for abnormal cervical cytology. This was not consistent with hypothesis by Winkelstein [21], and results reported by Plummer et al [13] which found a direct relationship between smoking, HPV infection and cervical cancer. Alcohol usage was recorded as a critical risk factor in this study. ...
... Tobacco use is also a known risk factor for cervical cancer 7 . Direct carcinogenic effect of cigarette smoking on the cervix is supported by the fact that nicotine metabolites can be found in cervical mucus of women smokers 8 . ...
The objective of our research was to compare the results of human papillomavirus (HPV) typing and occurrence of the most important risk factors for cervical cancer obtained in the towns of northern, central and southern regions of Montenegro, in subjects between 30 and 35 years of age, in accordance with the new screening program introduced by the Ministry of Health of Montenegro in 2018. The study included 400 patients aged 30-35 years from Rožaje, Berane, Budva and Podgorica, 100 from each town, who underwent HPV typing in accordance with the latest screening program for early detection and prevention of cervical cancer, approved by the Ministry of Health of Montenegro in 2018. The material was obtained and sampled at the Health Clinics in Rožaje, Berane, Podgorica and Budva. Specially designed brushes were used to take swabs from the cervices, which were then sampled in separate collection tubes that contained a liquid transport medium. The samples were then sent for further analysis to the Institute of Public Health of Montenegro where HPV typing was performed using the real-time polymerase chain reaction method. The results were encrypted and obtained electronically. The data obtained from the questionnaires each subject filled out in accordance with this program were analyzed and the subjects willingly agreed to partake in the screening program. Nearly one-quarter of subjects had a positive HPV finding. The group of HPV positive women included significantly more women from Podgorica (χ2-test=26.455, p<0.001), women with very good living conditions (χ2-test=12.264, p<0.001), women who smoked cigarettes (χ2-test=5.074, p=0.024), women who had the first sexual intercourse between the ages of 17 and 20 (χ2-test=5.874, p=0.015), and women who did not have permanent partners (χ2-test=6.061, p=0.014). Among the observed socio-demographic characteristics and sexual behaviors of our subjects that proved to be non-significant variables in their HPV statuses we excluded the length of smoking habit (χ2-test=0.638, p=0.424) and protected sexual intercourse (χ2-test=2.628, p=0.105). By implementing the screening program and HPV typing, we came to a conclusion that the problem of cervical cancer could be solved or at least mitigated by raising awareness of the causes and incidence of cervical cancer, as well as by being well informed on its curability, predictability and protection during intercourse, which would contribute to positive changes.
... In addition to the studies already quoted, a review on the association o f smoking and cervical cancer is worth mentioning (Winkelstein, 1990). A study suggesting a strong association between smoking and HSIL described that among 167 women, whose worst ever cervical smear was mild dyskaryosis, 60% o f smokers had HSIL compared to only 25% o f non-smokers (Luesley et al., 1994). ...
Cervical cancer is the second most common cancer in women worldwide and the highest incidence is found in Recife, Brazil. This thesis investigates the relationship between various local risk factors in Recife, including the sexually transmitted infection of high-risk human papillomavirus (HR HPV) types, age of first sexual intercourse and first pregnancy, number of sexual partners, the male factor, effect of hormonal status, methods of contraception, smoking habits and education status. Two methods of HR HPV detection were evaluated. These were the Hybrid Capture I assay which was available commercially at the start of the PhD project in 1997 and a technique previously developed in UCL involving polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). The association between individual risk factors and cervical lesions presenting with different cytological grades (ASCUS, mild dyskaryosis, moderate dyskaryosis, severe dyskaryosis and cancer) and histological grades (cervicitis, cervical intraepithelial neoplasia grades 1, 2 and 3 and cancer) was also investigated. Infection with HR HPV was found to be the major risk factor for cervical cancer in Recife as is the case worldwide. Poor socio-economical conditions, poor education and an inadequate cytological screening system also contributed to the high incidence of cervical cancer. The results presented in this thesis show that, relative to cytological screening, HR HPV detection by PCR/RFLP provides greater accuracy in the identification of women with risk to have cervical neoplasia, simpler specimen manipulation, no requirement for subjective interpretative skills and lower unit cost. In addition, the test increases coverage for all eligible women as it can be carried out safely during pregnancy when most women will attend at least one antenatal visit. The potentials and the problems of self-sampling as a means of further increasing coverage of the at risk population were also investigated. A cost-effective protocol is proposed based on HR HPV detection for the early identification of women in Recife with or at increased risk of developing cervical precancer and cancer.
... Links between cigarette smoking and cervical cancer were first observed in the late 1960s, with many subsequent investigations supporting this relationship (Daling et al., 1992, Giulano et al., 1997, Licciardone et al., 1989, Najuib et al., 1966, Prokopczyk et al., 1997, Winlelstein, 1990. Smoking prevalence in the Appalachian region of Ohio is estimated to be 28.2% among women, nearly 8% higher than the statewide estimate and 11% higher than the national estimate for women (American Cancer Society, 2007). ...
Objective:
The Community Awareness Resources and Education (CARE) project: Reducing Cervical Cancer in Appalachia is part of the NIH Centers for Population Health and Health Disparities initiative. It aims to increase screening rates for cervical cancer, to assist in tobacco cessation, and to determine the role of human papillomavirus (HPV) in contributing to the increased risk of cervical cancer.
Methods:
Eligible subjects were recruited from 14 clinics in Appalachian Ohio. The CARE cross sectional survey (CS) (571 participants) characterized social, behavioral, and environmental factors of Pap smear screening and smoking. The intervention projects tested programs to increase Pap smear screening (280 participants) or aid in smoking cessation (300 participants). A case control study (1360 participants) assessed social, behavioral, and biologic predictors of abnormal Pap tests.
Results:
The CS participants tended to be younger, more educated, and were more likely to be employed than the general population of Appalachian women 18 and over. They were similar to the other samples in terms of race, marital status, income level and smoking status.
Conclusions:
CARE will provide valuable information about the multi-level barriers to obtaining regular Pap smears and quitting smoking, as well as help to identify important biological and social risk factors related to abnormal Pap smears.
... Moreover, the combination of these two factors significantly decreases survival (DS and OS). Similar evidence has been reported previously [18][19][20][21]. Furthermore, according to our Cox hazard model (multivariate analysis) an early death risk is higher when at least one of the risk factors is present. ...
Background:
Survival of oropharyngeal squamous cell carcinoma (OSCC) patients depends on the risk and environmental factors, tumor biology, achievements in diagnostics and treatment approaches.
Aim:
To perform a survival analysis of the patients with OSCC treated over a 10-year period in a single hospital in Latvia linking these data to histopathological findings, risk factors and received therapy.
Materials and methods:
The main outcome measures were overall and disease-specific survival (OS and DS) along with histopathology analysis.
Results:
Kaplan - Meier survival analysis showed better survival for females, younger patients lacking bad habits, operated and received radiotherapy, with lower T grade and disease stage. Cox regression showed diminished early death risk in patients with lower T grade, no regional metastases (N0) and bad habits, operated and received radiotherapy. A vast majority of tumors were localized in palatine tonsils and the base of the tongue. The localization did not correlate with mean survival time/survival. Lower OS (p = 0.03) and DS (p = 0.026) were estimated for patients with pharyngeal wall and tonsillar involvement compared to tumors localized in the soft palate. A histological variant of tumor seemed irrelevant estimating OS and DS, whereas therapeutic modalities significantly affected survival.
Conclusions:
OSCC patients with lower T grade, N0 status, lacking bad habits, and surgically treated had better survival.
... Supportive pieces of evidence were obtained by using Cox hazard model (multivariate analysis), which showed a higher risk of early death when at least one of the factors -smoking and alcohol abuse was present. These results seem to be similar to the contention made by other scientists [9][10][11][12]. ...
Oropharynx is one of the most common localizations for malignant neoplasms in the head and neck region. HPV-positive OPSCCs are the most common subtypes in Western countries with tobacco and alcohol use, remaining the major risk factors for cancer development in this region. The study aims to address the significance of smoking and alcohol abuse in OPSCC cases and perform a survival analysis of the patients with OPSCC treated over a 10-year period in a single hospital in Latvia, correlating these data with patients' hazardous habits (smoking and alcohol abuse). Out of 247 patients, the majority were smokers (75.95%, n = 180), approximately one third were habitual drinkers (35.19%, n = 82) or were exposed to both aforementioned major risk factors (31.47%, n = 73). Kaplan-Meier survival analysis showed significantly better survival for the patients without the aforementioned hazardous habits. Cox regression analysis proved a higher early death rate when both factors (smoking and alcohol abuse) were present. It seems that smoking has a higher predictive value than alcohol abuse.
... [3,4] It is, therefore, important to be aware of the risk factors, screening techniques and available diagnostic options with special attention to the management of the pre-invasion disease. [2] The risk factors of cervical cancer include women with multiple sex partners, early age of first intercourse, history of venereal disease, [5] women whose male partners have multiple partners, [6] association with Human papilloma virus, [7] (a sexually transmitted virus, especially of the type 16,18,31,33), smoking [8,9] and early marriage. [10] Cervical cancer is associated with a broad age range. ...
This study is aimed at determining the prevalence of adenocarcinoma among the Igbos with cervical cancer and to assess the relative associations of such factors as age and parity on the disease.
... It is therefore important to be aware of the risk factors, screening techniques and available diagnostic options with special attention to the management of the pre-invasive disease (Cannista and Niloff, 1965). The risk factors include women with multiple sex partners, early age of first intercourse (Christopherson and Parker, 1965), history of veneral disease, (Kessfer, 1976), women whose male partner have multiple partners (Gendershot,1983;Martin,1967), association with human papilloma (Walboomerg et al., 1990;Luesley et al., 1994), sexually transmitted virus, and smoking (Winklestein, 1990;Luesley et al, 1994). ...
The aim of this study is to determine the prevalence of squamous cell carcinoma among the Igbos in Nigeria and to assess the relative associations of factors like age and parity on the disease. Reports on 206 histological diagnosed cervical cancer cases were reviewed. The tissue blocks of these cases were also retrieved and sectioned at 5µm with rotary microtome. They were then stained with hematoxylin and eosin techniques for general tissue architecture and diagnosis. The stained slides were then viewed and confirmed under high power microscope. Of this number, 125 (60.5%) had squamous cell carcinoma and some infiltration of eosinophils in some of the stroma adjacent to the tumour cells. Prime clinical findings included irregular vaginal bleeding, vaginal discharge, lower abdominal pain and post coital bleeding. The mean age of presentation was 62±6.4 years. Age and parity of the patients appeared to be significantly associated with prevalence of the disease. Early detection and prompt treatment of cervical cancer patients is recommended in order to reduce the associated and ever increasing rate of mortality and morbidity.
... 6. Well known risk factor for cervical cancer is tobacco smoking [24]. Nicotine metabolite can be found in the cervical mucus of women who smoke and there is high effect of carcinogenic action of cigarette on the cervix [25]. ...
Cervical cancer is a cancer arising from the cervix, which is usually also a sexually transmitted disease. The occurrence of the cancer is worldwide leading to deaths. However, the incidence and mortality due to cervical cancer has declined during last few decades in developed countries owing to the widespread use of cervical screening programs. However, approximately 70% of cervical cancers occur in developing countries due to lack of PAP screening and vaccine against causative agent. Almost all cervical cancers are caused by longstanding infection with one of the HPVs. The review article has given more emphasis on prevalence of cervical cancer and its preventive strategies in India especially Gujarat state. India is largest country in population size with less knowledge on sexually transmitted diseases and limited medical resources. Therefore, it needs more focus on cervical screening (PAP) strategy to lower the cervical cancer incidents. The article elucidates details of HPV, genetics of HPV, diagnosis of HPV, molecular diagnosis of HPV, Cervical cancer, strategies for screening methods and available test for cervical cancer diagnosis.
... The greatest risk factor for cervical cancer is type 16 and 18 human papillomavirus (HPV) infection, which accounts for 75% of cervical cancer cases (6). Smoking is the next most significantly associated risk factor for cervical cancer; the incidence of invasive cervical cancer is 2-3 times higher in current or former smokers among HPV-infected women (7). ...
The molecular mechanisms of cervical cancer have been minimally explored with multi-omics data. In the present study, mRNA expression profiles were analyzed and combined with predicted miRNA interactions to contribute to the characterization of the underlying regulatory mechanisms of cervical cancer. A total of 92 significantly differentially expressed genes (DEGs) were identified in 33 tumor samples by comparison with 29 normal samples. mRNA-miRNA interaction network analysis revealed that 16 out of the 92DEGs, including checkpoint kinase 1 (CHEK1), SRY-box 17 (SOX17), centrosomal protein 55, cyclin dependent kinase inhibitor 2A (CDKN2A), and inhibitor of DNA binding 4, were the targets of 4 miRNAs which were previously reported to be involved in the regulation of cervical cancer. Tumor and normal samples could be distinctly classified into two groups based on the expression of the 16 DEGs. Furthermore, survival analysis using the SurvExpress database indicated that the 16 DEGs could individually significantly differentiate low- and high-risk cervical cancer groups. Overall, multiple biological processes are likely to participate in the progression of cervical cancer based on the pathway and function enrichment identified for the DEGs. The dysregulation of SOX17 is associated with the regulation of embryonic development, the determination of cell fate and likely promotes cancer cell transformation. The dysregulation of CHEK1 and CDKN2A further promote cancer cell proliferation by affecting the cell cycle checkpoint in response to DNA damage. The identification of critical genes and biological processes associated with cervical cancer may be beneficial for the exploration of the molecular mechanisms.
... Therefore, the role of persistent infection with oncogenic types of HPV in the etiology of cervical cancer has encouraged the evaluation of HPV testing as a screening tool (IARC, 1995;Bosch et al., 2002;Franco, 2003). Cigarette smoking is the only nonsexual behavior consistently and strongly correlated with cervical cancer, independently increasing risk two-to four fold (Winkelstein, 1990). ...
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.
... One of these factors is tobacco smoking. DNA adducts of bulky aromatic compounds have been found more frequently in cervical epithelium of smokers than in that of nonsmokers, providing biochemical evidence that tobacco may play a major role in the etiology of cervical cancer (3). ...
Background
The etiology of cervical cancer is associated with excessive–inflammation-mediated tumorigenesis. Interleukin-6 ( IL-6), a multifunctional cytokine, regulates inflammation and various physiological processes. We therefore aimed to evaluate the association of the IL-6 –174G>C polymorphism with predisposition to cervical cancer.
Materials and methods
The present case-control study comprised 160 histopathologically confirmed cases of cervical cancer and 200 healthy controls. Polymorphism for the IL-6 gene was genotyped by amplification refractory mutation system (ARMS) polymerase chain reaction (PCR).
Results
We observed a significant association of the IL-6 –174CC genotype with risk of cervical cancer (OR=3.16; p=0.014). An increased risk of developing stage I tumors was found in individuals with a heterozygous (GC) genotype (OR=3.63, p=0.003). In a case-only analysis, the risk was further increased in patients consuming tobacco products (OR=3.14; p=0.033).
Conclusion
The CC genotype in the IL-6 promoter region may confer a high risk of cervical cancer, which is further modulated in patients who are tobacco users.
... While HPV is a major factor for developing CC, and given that persistent infection with a high-risk "oncogenic" type of HPV appears to be necessary for the development of invasive CC (Walboomers et al., 1999;Munoz et al., 2003), a number of studies have shown that squamous cell CC may result from an additive or synergistic interaction between oncogenic HPVs and cervical tar exposures, a process generally referred to as co-carcinogenesis (Haverkos, 2004 2007). We highlight coal tar derivatives from cigarette smoking, tar-based vaginal sanitization products, and inhaled smoke from burning biomass (wood, coal, dung) in poorly ventilated kitchens, as potential co-carcinogenic factors that contain bioactive compounds likely to play a determinative role in CC development (Rotkin, 1967;Winkelstein, 1990;Ferrara et al., 2000;Haverkos et al., 2000Haverkos et al., , 2003Velema et al., 2002;Steckley et al., 2003 Bennett et al., 2010). We identify published data from virological and genetic studies linking oncogenic papillomavirus genotypes and chemicals to development of cancer (Rous, 1965;Prokopczyk et al., 2009;Wei et al., 2014). ...
Cervical cancer (CC) is the fourth most common cancers among women worldwide. Human papillomaviruses (HPVs) play a major role in the etiology of CC, with several lines of epidemiologic and experimental evidence supporting a role for non-viral (co-carcinogens) and host genetic factors in controlling the risk for progression to neoplasia among HPV-infected individuals. The role of co-carcinogens in the development of CC is significant in the developing world where poor sanitation and other socioeconomic conditions increase the infectious cancer burden. Here, we discuss how exposure to environmental factors such as coal tar derivatives from cigarette smoking, tar-based sanitary products, and inhaled smoke from biomass-burning stoves, could activate host pathways involved in development of HPV-associated squamous cell cancers in resource-limited settings. Understanding interactions between these pathways with certain oncogenic HPV genotypes may guide implementation of strategies for control and treatment of HPV-associated cancers that develop in populations at high risk of exposure to various co-carcinogens.
... Sexual behavior has indeed changed during the last decades and the role of oncogenic sexually transmitted HPV infection might have grown in the development of cervical cancer [2] as the life time number of sexual partners has increased [27] and the age of onset of sexual life has decreased [27]. Further, tobacco smoking, which decreases the clearance of HPV and increases the risk of cervical cancer [28] [29], [30], increased in the 1980′s among young women and stayed on that level before starting to slightly decrease in the 2000′s [31] [32],. Nevertheless we cannot rule out that more frequent screening could have some effect on the incidence of cervical cancer also in women younger than 35 years. ...
Objective:
Effectiveness of organized cervical cancer screening has been shown in several studies. However, screening among women aged <25years has been suggested to have little or no impact on the risk of cervical cancer. Also the significance of opportunistic testing in preventing cervical cancer is unclear. The aim of this study was to clarify the effect of opportunistic testing and organized screening on the risk of cervical cancer among young Finnish women.
Methods:
In the Finnish Cancer Registry there were 284 cervical cancer cases diagnosed and tested below the age of 40 in 2004-2009. Screening histories and data on opportunistic testing for these women and their 1698 age-matched controls were derived from databases of the Mass Screening Registry and The National Institute for Health and Welfare from 1997 onward. OR's and 95% CI's for the association of cervical cancer diagnosis and participation in organized screening and opportunistic testing were estimated using unconditional logistic regression. Results were corrected for self-selection bias and attendance rate.
Results:
Among women aged under 25, OR of cervical cancer for any Pap test taken 0.5-5.5years before diagnosis was 1.25 (95% CI 0.46-3.43). Attending only organized screening at age 25-39 resulted in OR 0.52 (0.36-0.77), attending only opportunistic testing in OR 0.86 (0.60-1.25) and attending both in OR 0.48 (0.29-0.79).
Conclusion:
Opportunistic testing showed no clear additional benefit on preventing cervical cancer. The study also supports findings on a smaller effect of screening in younger age groups.
... In developing countries like Bangladesh there is no effective screening program. Risk factors for cervical cancer include early age at first intercourse, history of multiple sexual partners, and smoking [5][6][7][8] . The U.S preventive services task force recommends that cervical cancer screening be performed in all women with a cervix who are or have been sexually active. ...
During the period of July-2005 to June 2006 a total 100 women under went pap testing in Dinajpur, Bangladesh. The aim of the study was to observe the pattern of histological changes in cervical epithelia among sexually active women in Dinajpur. Results of Pap's test revealed inflammatory changes in 69%, cases, inflammatory with squamous metaplasia in 23% cases, normal 6%, atypia 1% & dyskaryosis in 1% case. doi: 10.3329/taj.v19i2.3155 TAJ 2006; 19(2): 76-80
... The sensitivity could attain 100% when the DNA is qualitatively adequate. Finally, there are cases where some factors as smoking and HIV infection are very important co-factors for progression to high-grade lesions than HPV alone [5,19]. We identified 9 types of HPV genotypes in 39 isolates of HPV. ...
The objectives of this study were to detect and determine the different genotypes of Human Papillomavirus (HPV) found in high-grade squamous preinvasive lesions of the uterine cervix of Cameroonian women. HPV genotyping was conducted on 37 endocervical secretions of women with high grade squamous intraepithelial lesions. HPV was found in 31 of the 37 women (83.8%); 9 different HPV genotypes were identified. The genotypes with high oncogenic potential were found in decreasing order of frequency as follows: 16, 18, 45, 33, 35 and 68. The frequency of strains found per patient ranged from 1 to 3. Genotypes 16 and 18 were single in 17 out of 31 patients. They were associated with other HPV genotypes in 4 out of 31 patients. In this study genotypes 16 and 18 are the most frequent genotypes encountered in high grade squamous preinvasive cervical lesions in Yaounde. This finding, if confirmed on a larger sample, portrays the potential effectiveness of HPV vaccines in the Cameroonian population as a preventive measure against cervical cancer. However, the position of genotype 45 is not negligible and should be confirmed on a large sample.
... The sensitivity could attain 100% when the DNA is qualitatively adequate. Finally, there are cases where some factors as smoking and HIV infection are very important co-factors for progression to high-grade lesions than HPV alone [5,19]. ...
The objectives of this study were to detect and determine the different genotypes of Human Papillomavirus (HPV) found in high-grade squamous preinvasive lesions of the uterine cervix of Cameroonian women. The age of the effected women was 28-55 years with 27 (69.3%) women between 34 and 40 years old. HPV genotyping was conducted on 37 endocervical secretions of women with high grade squamous intraepithelial lesions. HPV was found in 31 of the 37 women (83.8%); 9 different HPV genotypes were identified. The genotypes with high oncogenic potential were found in decreasing order of frequency as follows: 16, 18, 45, 33, 35 and 68. The frequency of strains found per patient ranged from 1 to 3. Genotypes 16 and 18 were single in 17 out of 31 patients. They were associated with other HPV genotypes in 4 out of 31 patients. In this study genotypes 16 and 18 are the most frequent genotypes encountered in high grade squamous preinvasive cervical lesions in Yaounde. This finding, if confirmed on a larger sample, portrays the potential effectiveness of HPV vaccines in the Cameroonian population as a preventive measure against cervical cancer. However, the position of genotype 45 is not negligible and should be confirmed on a large sample.
... How could our observations of a strong effect of smoking restricted to premenopausal women be explained? Previous discussions as to how smoking may alter the risk of anogenital cancer have focused on the possible role of chemical carcinogens in tobacco smoke, smokemediated immunologic changes, or low levels of nutritional antioxidants in smokers (13). However, such mechanisms should plausibly entail a similar effect in premenopausal and postmenopausal women and in men. ...
Artificial intelligence (AI) and machine learning (ML) methods are increasingly adopted in cyberattacks. AI supports the establishment of covert channels, as well as the obfuscation of malware. Additionally, AI results in new forms of phishing attacks and enables hard-to-detect cyber-physical sabotage. Malware creators increasingly deploy AI and ML methods to improve their attack’s capabilities. Defenders must therefore expect unconventional malware with new, sophisticated and changing features and functions. AI’s potential for automation of complex tasks serves as a challenge in the face of defensive deployment of anti-malware AI techniques. This article summarizes the state of the art in AI-enhanced malware and the evasion and attack techniques it uses against AI-supported defensive systems. Our findings include articles describing targeted attacks against AI detection functions, advanced payload obfuscation techniques, evasion of networked communication with AI methods, malware for unsupervised-learning-based cyber-physical sabotage, decentralized botnet control using swarm intelligence and the concealment of malware payloads within neural networks that fulfill other purposes.
Overview
Cervical cancer is the third most common cancer among women worldwide and the fourth leading cause of female cancer deaths, with an estimated 529,800 new cases and 275,100 deaths in the year 2008. The incidence is declining in the United States with 13,800 new cases and 4290 deaths in 2015. Squamous cell carcinoma is the most common histology with the human papilloma virus being the most common etiology. Cervical cancer and precancer can be easily detected with pap smears and HPV testing and prevented with HPV vaccine. Early‐stage cervix cancer can be treated with surgery including now fertility‐sparing surgery and there are high cure rates. Locally advanced cervical cancer is treated with combination of chemotherapy and radiation therapy with high survival rates but there is room for improvement with advancing stage. Systemic chemotherapy can be used for treatment of both recurrent and metastatic disease, but careful attention should be paid to balancing benefit and toxicity. The key to improving overall outcomes will be translating the success seen in developed countries to areas of the world where advanced‐stage invasive cervical cancer is most common.
Human papilloma virus (HPV) infection is a major cause of cervix cancer, but a number of infected women do not develop invasive lesions, suggesting that HPV infection in itself is not a sufficient factor and that other cofactors, such as smoking, play an important role in development of cervix cancer. Alongside active cigarette smoking, passive smoking is an independent risk factor for cervix cancer. Smoking maintains cervical HPV infection longer and decreases potential of clearing an oncogenic infection. Thus, it is quite possible that polymorphism at detoxifying enzyme coding loci such as GSTM1, GSTT1, and GSTP1 may determine susceptibility to cervix cancer. This study evaluates the combined effects of genetic polymorphisms of GSTM1, GSTT1, and GSTP1 on susceptibility to cervical cancer and interaction of these genes with smoking. On individual analysis of GSTM1, GSTT1, and GSTP1, it was observed that passive smokers having genotypes GSTM1 (null) (OR = 7.0, 95% CI = 2.19-22.36, P = 0.0005), GSTT1 (null) (OR = 10.2, 95% CI = 1.23-84.18, P = 0.02), and GSTP1 (ile/val) (OR = 6.4, 95% CI = 2.25-18.38, P = 0.0005) have an increased risk of developing cervix cancer. It is thus concluded that cervical cancer risk is increased in passive smokers with GSTM1 (null), GSTT1 (null), and GSTP1 (ile/val) genotypes.
The purpose of this review is to describe the existing literature regarding the relationship between the vaginal microbiome, human papillomavirus persistence, and cervical cancer risk, as well as to discuss factors that mediate these relationships. Data suggest that alterations in the vaginal microbiome affect the risk of human papillomavirus infection and persistence, which has downstream effects on cervical dysplasia and cancer risk. The homeostatic Lactobillus species L. crispatus, L. gasseri, L. jensenii act to promote a healthy vaginal environment, while L. iners and pathogens causing bacterial vaginosis are associated with increased inflammation, human papillomavirus infection, cervical dysplasia, and potentially cancer. There are, however, still several large gaps in the literature, particularly related to the modifiable and non-modifiable factors that affect the vaginal microbiome and ensuing risk of pre-cancerous and cancerous lesions. Evidence currently suggests that endogenous and exogenous hormones, tobacco products, and sexual practices influence vaginal microbiome composition, but the nuances of these relationships and how changes in these factors affect dysplasia risk are yet to be delineated. Other studies examining how diet, exercise, race, socioeconomic status, and genetic factors influence the vaginal microbiome are difficult to interpret in the setting of multiple confounders. Future studies should focus on how changes in these modulatory factors might promote a healthy vaginal microbiome to prevent or treat dysplasia in the lower female genital tract.
Background: Cervical cancer is the most common cancers in female population of Nepal. Though considered a slow growing cancer, majority of patients still present very late. Methodology: One hundred patients of cancer cervix were retrospectively analysed to see their spectrum of clinical presentation and care pathway from January 2012 to April 2012. Results: The clinical spectrum showed they presented to clinic after average of 9 months of symptoms. Squamous cell cancers were the main histology. Majority of cases were in FIGO stage of II and IIIB. Radiation therapy with tele-therapy and brachytherapy was the main modality of treatment (94%) of cases. Conclusion: Late stage of presentation is a very common phenomenon in the patients with cancer of cervix. Need screening programs in systematic manner to detect early stage diseases and for better care.
سرطان یکی از مهم ترین علت های مرگ در کشور عزیزمان ایران است. از آنجا که انواع بسیاری از سرطان ها قابل پیشگیری هستند، وظیفه نظام سامت و همچنین متخصصان علوم سلامت است که دانش، مهارت و امکانات لازم برای پیشگیری و یا تشخیص به هنگام سرطان را برای افراد جامعه فراهم نمایند. این کتاب کوششی در راستای انجام وظیفه اطلاع رسانی، آگاهی افزایی و توانمندسازی افراد جامعه برای پیشگیری از انواع سرطان و مراجعه به موقع به مراکز تشخیصی و درمانی، در صورت مشاهده و تجربه علایم اولیه سرطان است.
هدف تدوین و ارایه کتاب، همه آنچه لازم است مردم برای پیشگیری از سرطان را بدانند، بر مبنای شواهد محکم و مستدل علمی و به زبان قابل درک مخاطبانی است که تحصیلات غیر علوم سلامت دارند و یا فاقد تحصیلات دانشگاهی هستند.
این کتاب، محصول یک طرح پژوهشی است که با حمایت مالی مرکز تحقیقات سرطان دانشگاه علوم پزشکی تهران و تلاش فراوان تیمی از متخصصن ممکن گردیده
است. لازم به ذکر است که روند کار بدین گونه بود که، بعد از تعیین نویسندگان فصول و تدوین راهنمای تالیف فصول، پیش نویس اول هر فصل بر اساس راهنمای
تالیف توسط نویسندگان تهیه می گردید. سپس از نظر مناسب بودن برای مخاطب کتاب، روانی مطلب و مستند بودن مناسب مطالب، مورد ارزیابی قرار می گرفت و
برای اصلاح مجدد به نویسنده ارسال می گردید. نسخه دوم مجددا برای بار آخر مورد ارزیابی علمی قرار میگرفت و نهایتا ویرایش ادبی اعمال می گردید. بنابر این هر
فصل چندین بار اصلاح و حتی بازنویسی شده است. لذا در اینجا لازم است به عنوان مجری طرح از همه اعضای تیم که برای تالیف فصلهای مختلف کتاب و اصلاحات
چندباره آن، با دقت نظر و حوصله فراوان، ساعت های بسیاری از وقت ارزشمند خود را صرف نمودند نهایت تشکر را بنمایم.
اما در آخر بر خود واجب می دانم به طور ویژه از زحمات سرکار خانم دکتر کبری نوری و آقای دکتر کاظم زنده دل که بدون همکاری ایشان این کتاب به اتمام نمی رسید، تشکر نمایم. امیدواریم این تلاش گروهی، گامی هر چند کوچک در مسیر ارتقای سلامت مردم عزیز کشورمان باشد.
Overview
Cervical cancer is the fourth most common cancer among women worldwide and the fourth leading cause of cancer deaths in females, with an estimated 529,800 new cases and 275,100 deaths in the year 2008. The incidence is declining in the United States with 12,900 new cases and 4100 deaths in 2015. Squamous cell carcinoma is the most common histology, with the human papilloma virus (HPV) being the most common etiology. Cervical cancer can be easily prevented with pap smears, HPV testing, and hopefully the HPV vaccine. Early‐stage cervix cancer can be treated with surgery including now fertility sparing surgery, and there are high cure rates. Local advance cervical cancer is treated with a combination of chemotherapy and radiation therapy with high survival rates, but there is room for improvements with advancing stage. Systemic chemotherapy can be used for treatment of both recurrent and metastatic disease, but careful attention should be paid to balancing benefit and toxicity. The key to success will be the transportation of success seen in the developing countries to success in the areas of the world where advanced‐stage invasive cervical cancer is most common.
Objective: Among the more than thousands of papers, reviews, commentaries and editorials published on the theme of ill health due to smoking tobacco products, I present an overview of the literature mostly published since 1980. Commentary: In 1908, less than 10 chemical compounds were identified from tobacco smoke. Now, this number has increased to over 8,000. Literature on the reviews in 30 interrelated themes covering the pathophysiology of smoking and representative studies that had focused on the damage to reproductive and other sensory systems due to nicotine use and tobacco smoke inhalation are presented in two tables. Recent revelations on the tobacco industry's nefarious links to the Hollywood movie industry as well as the expose of the research funding offered by the tobacco industry to leading medical researchers Hans Selye and Ernst Wynder are also highlighted. Conclusion: With the rising popularity of electronic cigarettes to a new generation of smokers in the past decade, services of specialty journals such as Tobacco Control, Tobacco Induced Diseases, as well as Nicotine and Tobacco Research becomes vital to combat the abuse of nicotine.
The purpose of this study was to find out the clinocopathologic characteristics, post-operative findings and
complications of patients with early (up to stage IIA) cervical carcinoma who underwent radical hysterectomy.
This study concentrates on the evaluation of our early experience in radical hysterectomy for cervical
cancer in Nepal. This was a retrospective analysis of 48 patients who had radical hysterectomy with bilateral
pelvic lymphadenectomy for early cervical cancer at the BP Koirala Memorial Cancer Hospital (BPKMCH)
from September 1999 through September 2002. Characteristics such as chief complaint, disease staging
and duration, intraoperative and postoperative complications, histopathological findings, need for blood
transfusion, and duration of hospital stay were considered for analysis. Patients’ age ranged from 28-67
years. Age group of 40-49 had highest number of patients (58.3%). Majority (62.5%) were premenopausal
women who presented with abnormal vaginal bleeding (73%) as the chief complaint. More than half of
them (56%) had FIGO stage IIA disease. Thirty-three percent had intraoperative and postoperative
complications such as urinary problems, wound infection and vessel injury/ureteric injury. All needed
blood transfusion, 42% needing four pints. The average duration of hospital stay was 11 days. Forty-four
had squamous cell carcinoma and four had adenocarcinoma. Pelvic lymph node metastasis was found in 10
patients. Resected margins were adequate in 42 patients. Majority (62.5%) of the women were premenopausal
and 56% of them had stage IIA disease. Although the primary treatment of early-stage cervical carcinoma
involves either surgery or radiation therapy with or without chemotherapy, surgery (radical hysterectomy)
was used for lower-stage disease and smaller lesions in fit and young patients in our resource-poor set-up.
Fifteen patients needed postoperative radiation. The complication rate seems to be higher in Nepal; however,
it will decrease as more experience is gained.
Key Words: Cervical cancer, gynecological malignancies, human papillomavirus, radical hysterectomy.
Le tabac est responsable de 100 millions de morts dans le monde au cours duXXème siècle, et est, à ce titre, désigné comme la première cause de morts évitables par l'O.M.S. La première zone d'exposition à la combustion du tabac étant la bouche, celle-ci est directement agressée par ce poison. Que ce soit les dents, le parodonte, ou bien les différentes muqueuses, la cavité buccale dans son ensemble subit des modifications cliniques et développe des pathologies conséquemment au tabagisme. Le chirurgien dentiste, professionnel de santé, est au premier plan pour lutter activement contre ce fléau.Il a un devoir de connaissance pour déceler rapidement les prémices d'uneéventuelle pathologie induite par le tabac, mais également un devoir d'informationenvers le patient. Il se doit de l'accompagner vers un éventuel sevrage et, pour cefaire, connaître le panel de thérapeutiques pouvant aider à s'affranchir de cettedrogue.
Cigarette smoking has been associated with both the diagnosis of bacterial vaginosis (BV) and a vaginal microbiota lacking protective Lactobacillus spp. As the mechanism linking smoking with vaginal microbiota and BV is unclear, we sought to compare the vaginal metabolomes of smokers and non-smokers (17 smokers/19 non-smokers). Metabolomic profiles were determined by gas and liquid chromatography mass spectrometry in a cross-sectional study. Analysis of the 16S rRNA gene populations revealed samples clustered into three community state types (CSTs) ---- CST-I (L. crispatus-dominated), CST-III (L. iners-dominated) or CST-IV (low-Lactobacillus). We identified 607 metabolites, including 12 that differed significantly (q-value < 0.05) between smokers and non-smokers. Nicotine, and the breakdown metabolites cotinine and hydroxycotinine were substantially higher in smokers, as expected. Among women categorized to CST-IV, biogenic amines, including agmatine, cadaverine, putrescine, tryptamine and tyramine were substantially higher in smokers, while dipeptides were lower in smokers. These biogenic amines are known to affect the virulence of infective pathogens and contribute to vaginal malodor. Our data suggest that cigarette smoking is associated with differences in important vaginal metabolites, and women who smoke, and particularly women who are also depauperate for Lactobacillus spp., may have increased susceptibilities to urogenital infections and increased malodor.
Background
The effect of smoking on human papillomavirus (HPV) activity and subsequent dysplasia and neoplasia remains controversial
Objective
To determine any reported effects of smoking on either HPV activity or HPV-related dysplasia/cancer using retrospective analysis of the literature from 1966 through 1998 via Toxline and PubMed to search for “smoking,” “papillomavirus,” and “cancer.”
Conclusion
Several recent large studies demonstrated that smoking was associated with a greater incidence of cervical, vulvar, penile, anal, oral, and head and neck cancer in a dose-dependent fashion, while other studies did not show any correlation between smoking and cervical dysplasia after multivariate adjustment. Recent studies have also indicated that smoking may be more closely related to high-grade lesions of the cervix and vulva. These data provide evidence of an association between HPV, smoking, and cancer. Progression of dysplasia likewise seems to be associated with smoking. Several groups have attempted to discern whether the connection between smoking and cervical cancer is from local immunosuppression and/or from direct carcinogenic effects.
Cigarette smoke (CS) is well known to be very harmful to human body functions such as fertility, reproduction, and development. CS is considered to more affect patients with hypertension (HT). To estimate the effect of CS associated with female rat’s fertility, we examined the histopathological characteristics of the uterus and ovary which were obtained from the female rats exposed to smoke of the standard cigarette (3R4F) for 4 weeks (10 h a week) according to the OECD guidelines. The female wild-type Wistar Kyoto (WK) rats (WTR) and spontaneously hypertensive WK rats (SHR) were used to compare the effect of CS on healthy and hypertensive rats. After CS exposure, we manufactured tissue slides from uterine and ovarian samples and evaluated the maturation of follicles of ovary and cell proliferation in the uterus by H&E staining and immunohistochemistry (IHC). In IHC analysis on ovarian tissues, the expression of proliferating cell nuclear antigen (PCNA) and the number of follicles were decreased by CS exposure. On the contrary, PCNA expression and cell proliferation in the uterine inner layers were increased by CS exposure. The protein expression of C/EBP homologous protein (CHOP), an endoplasmic reticulum (ER)-stress marker, and BAX, a pro-apoptotic protein, was decreased by CS exposure. This phenomenon was more exacerbated in SHR rats than in WTR rats. Taken together, acute exposure to CS induced the decreased maturation of ovarian follicles and abnormal over-growth of uterine inner wall, leading to a harmful effect on female rat’s normal function. In addition, this harmful effect of CS may be displayed more seriously in rats with HT.
Overview
Cervical cancer is the third most common cancer among women worldwide and the fourth leading cause of cancer deaths in females, with an estimated 529,800 new cases and 275,100 deaths in the year 2008. The incidence is declining in the United States with 12,900 new cases and 4100 deaths in 2015. Squamous cell carcinoma is the most common histology with the human papilloma virus (HPV) being the most common etiology. Cervical cancer can be easily prevented with pap smears, HPV testing, and hopefully the HPV vaccine. Early stage cervix cancer can be treated with surgery including now fertility sparing surgery and there are high cure rates. Local advance cervical cancer is treated with combination of chemotherapy and radiation therapy with high survival rates but there is room for improvements with advancing stage. Systemic chemotherapy can be used for treatment of both recurrent and metastatic disease, but careful attention should be paid to balancing benefit and toxicity. The key to success will be the transportation of success seen in the developing countries to success in areas of the world where advanced‐stage invasive cervical cancer is most common.
Background. Several epidemiological investigations have shown that cigarette smoking leads to increased serum IL-6 levels and is a risk factor for cervical cancer.Methods. We examined the levels of interleukin 6 (IL-6) and the amount of cotinine in the cervical fluid of 78 women and compared the presence of human papillomavirus (HPV) in smokers and nonsmokers.Results. The results of our study showed that IL-6 levels were higher in the cervical mucus of smokers than in nonsmokers. Fourteen percent of smokers were in the category with highest IL-6 levels compared to 6% of nonsmokers. However, our IL-6 results were not significant as they were probably influenced by the higher rates of HPV infection in smokers (17 cases) than in nonsmokers (4 cases). Significant findings showed that smokers had a higher prevalence of squamous intraepithelial lesions (SILs) than nonsmokers. Smokers' cotinine levels also exceeded those of nonsmokers: 13.95 ng/ml compared with 5.00 ng/ml. However, less IL-6 activity was evident...
Das Zervixkarzinom ist nach dem Endometriumkarzinom das zweithäufigste Genitalkarzinom und nach dem Mammakarzinom, dem kolorektalen Karzinom und dem Endometriumkarzinom der vierthäufigste bösartige Tumor der Frau. Bei den Inzidenzraten bestehen größere geographische Unterschiede. Die niedrigste Inzidenzrate mit 4,5 jährlichen Neuerkrankungen auf l00 000 Frauen wurde in Israel registriert. In den USA fanden sich 10, in Schweden 14, in Dänemark 23, in der ehemaligen DDR 31 und in Kolumbien 64 jährliche Neuerkrankungen pro 100 000 Frauen (Lohe u. Baltzer 1984; Waterhouse et al. 1976).
When a woman develops symptoms relating to her breasts she may become very anxious and look to a number of sources for support and reassurance. This chapter will address the issue of breast cancer, its development, predisposing factors, investigation procedures and the various treatment options that are currently available to women who develop the disease, plus the effects and side effects of these treatments. Breast cancer screening and nursing interventions for women undergoing therapeutic management will be discussed in order to raise awareness of nurses who will come into contact with breast cancer sufferers in both a professional and personal capacity. The second section of this chapter will adopt a similar approach to cancer of the cervix, as cancer of these two organs is very common and has caused high levels of morbidity and mortality throughout the world.
Shortly after the discovery of the first tumor virus by Rous (1) in 1911 and the first experimental demonstration of chemical induction of cancer in rabbit skin by painting coal tar by Yamagiwa and Ichikawa (2) in 1915, Rous and Kidd (3, 4) reported that tar enhanced the carcinogenic activity of the Shope papillomavirus for the rabbit skin. Since then, numerous reports of interaction between viruses and chemical carcinogens have been published (revs. 5–15) with the majority of these showing synergism. These findings have attracted increasing attention as evidence is mounting that human populations are often exposed to both viruses and chemical carcinogens and that the high incidence of human cancer in certain geographic areas can be attributed to viral-chemical synergistic action. The focus of this section is to review studies indicative of viral-chemical interaction in tumorigenesis in humans, experimental animals, and cell culture systems.
Zu den sicheren und reversiblen Verhütungsmethoden bei der Frau zählen heute in erster Linie die orale Kontrazeption und die Inträuterinspirale. Für den Mann steht heute außer Kondom und Sterilisation noch keine vergleichbare Methode zur Verfügung.
Genital tract cancer afflicts a significant portion of postmenopausal women. These malignancies make up 13% of all cancers in females. Approximately 75,300 new cases were diagnosed and 25,200 deaths resulted from gynecologic cancers in 1994.1 Risk of developing a gynecologic cancer increases with age.2 Figures 24.1 and 24.2 show the age-related incidence and mortality of these malignancies. As with other cancers, early detection provides the best opportunity for successful management. Therapeutic strategies include surgery, chemotherapy, and radiation treatment. Integration of these divers modalities is the raison d’être of gynecologic oncologists, who possess skills necessary to accomplish surgical and medical treatment of these women as well as knowledge of appropriate circumstances for strategic use of radiotherapy.
Most pathologists are part-time epidemiologists as well. The two medical disciplines are more closely allied than most realize. Epidemiologists study the distribution and determinants of diseases in human populations. In current medical practice, diseases often are defined by histopathological diagnoses or by clinical pathological test values. Thus, whenever a pathologist shifts intellectually from the level of the individual slide or specimen to thinking about a group of diagnoses, an informal epidemiologic question is being raised. For example, “How common is this diagnosis?” is a question of prevalence or incidence. “Why am I seeing so many cases of this type of tumor?” is a question of time trends. “How would my colleague interpret these slides compared with me?” is a question of interpathologist agreement. “What causes this disease I am seeing every week?” is a question of etiology that can be addressed by pathologists working as epidemiologists, or with them.
Inadequate supply of dietary vitamin A is a risk factor of cervical. neoplasia (La Vecchia et al. 1984), and retinoic acid or beta-carotene administration might protect against the effects of such risk factors of cervical. neoplasia as human papillomavirus (HPV), and smoking (Winkelstein 1991). Since HPV infections are common and vitamin A intake is vital, it is necessary to try to define their possible interactions. At least three subsidiary interactions exist: 1. Lack of dietary vitamin A increases susceptibility to infections (Sommer 1993) and impairs the subsequent immune response (Ross 1992). 2. HPV replication takes place in intermediate and superficial. keratinocytes (Howley 1990), the differentiation of which is largely determined by retinoic acid (Gorodeski et al. 1990). 3. Retinoic acid receptors downregulate expression of early HPV genes including the viral. oncogenes E6 and E7 (Khan et al. 1993), while in the papillomavirus transformed cells and cervical. neoplasia expression of cellular retinol and retinoic acid binding proteins is upregulated (Hillemanns et al. 1992).
