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Overexpression of HPV-oncoproteins E6 and E7 is necessary for HPV-driven cervical carcinogenesis. Hence, these oncoproteins are promising disease-specific biomarkers. We assessed the technical and operational characteristics of the 8-HPV-type OncoE6/E7 Cervical Test in different laboratories using cervical samples from HPV-positive women living with (WLWH) and without HIV. The 8-HPV-type OncoE6/E7 Test (for short: "OncoE6/E7 test") was performed in 2833 HIV-negative women and 241 WLWH attending multicentric studies in Latin America (ESTAMPA study), and in Africa (CESTA study). Oncoprotein positivity were evaluated at each testing site, according to HIV status as well as type-specific agreement with HPV-DNA results. A feedback questionnaire was given to the operators performing the oncoprotein test to evaluate their impression and acceptability regarding the test. The OncoE6/E7 test revealed a high positivity rate heterogeneity across all testing sites (I 2 : 95.8%, p < .01) with significant lower positivity in WLWH compared to HIV-negative women (12% vs 25%, p < .01). A similar HPV-type distribution was found between HPV DNA genotyping and oncoprotein testing except for HPV31 and 33 (moderate agreement, k = 0.57). Twenty-one laboratory technicians were trained on oncoprotein testing. Despite operators' concerns about the time-consuming procedure and perceived need for moderate laboratory experience, they reported the OncoE6/E7 test as easy to perform and user-friendly for deployment in resource-limited settings. The high positivity rate variability found across studies and subjectivity in test outcome interpretation could potentially results in oncoprotein false positive/negative, and thus the need for further refinements before implementation of the oncoprotein testing in screen-triage-and-treat approaches is warranted., (© 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)

Introduction: Although the burden of cervical cancer in Africa is highest, HPV vaccination coverage remains alarmingly low in this region. Providers' knowledge and recommendation are key drivers of HPV vaccination uptake. Yet, evidence about providers' knowledge and recommendation practices about the HPV vaccine against a backdrop of emerging vaccine hesitancy fueled by the COVID-19 pandemic is lacking in Africa., Methods: A cross-sectional study was conducted in 2021-2022 among healthcare providers involved in cervical cancer prevention activities in Africa. They were invited to report prior training, the availability of the HPV vaccine in their practice, whether they recommended the HPV vaccine, and, if not, the reasons for not recommending it. Their knowledge about the HPV vaccine was assessed through self-reporting (perceived knowledge) and with three pre-tested knowledge questions (measured knowledge)., Results: Of the 153 providers from 23 African countries who responded to the survey (mean age: 38.5 years, SD: 10.1), 75 (54.0%) were female and 97 (63.4%) were based In countries with national HPV immunization programs. Overall, 57 (43.8%) reported having received prior training on HPV vaccine education/counseling, and 40 (37.4%) indicated that the HPV vaccine was available at the facility where they work. Most respondents (109, 83.2%) reported recommending the HPV vaccine in their practice. Vaccine unavailability (57.1%), lack of effective communication tools and informational material (28.6%), and need for adequate training (28.6%) were the most commonly reported reasons for not recommending the HPV vaccine. While 63 providers (52.9%) reported that their knowledge about HPV vaccination was adequate for their practice, only 9.9% responded correctly to the 3 knowledge questions., Conclusion: To increase HPV vaccination coverage and counter misinformation about this vaccine in Africa, adequate training of providers and culturally appropriate educational materials are needed to improve their knowledge of the HPV vaccine and to facilitate effective communication with their patients and the community., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Fokom Domgue, Dille, Kapambwe, Yu, Gnangnon, Chinula, Murenzi, Mbatani, Pande, Sidibe, Kamgno, Traore, El Fazazi, Diop, Tebeu, Diomande, Lecuru, Adewole, Plante, Basu, Dangou and Shete.)

Competing Interests: We declare no competing interests.

Background: Cervical cancer is a significant public health problem, with 570,000 new cases and 300,000 deaths of women per year globally, mostly in low- and middle-income countries. In 2018 the WHO Director General made a call to action for the elimination of cervical cancer as a public health problem., Main Body: New thinking on programmatic approaches to introduce emerging technologies and screening and treatment interventions of cervical precancer at scale is needed to achieve elimination goals. Implementation research (IR) is an important yet underused tool for facilitating scale-up of evidence-based screening and treatment interventions, as most research has focused on developing and evaluating new interventions. It is time for countries to define their specific IR needs to understand acceptability, feasibility, and cost-effectiveness of interventions as to design and ensure effective implementation, scale-up, and sustainability of evidence-based screening and treatment interventions. WHO convened an expert advisory group to identify priority IR questions for HPV-based screening and treatment interventions in population-based programmes. Several international organizations are supporting large scale introduction of screen-and-treat approaches in many countries, providing ideal platforms to evaluate different approaches and strategies in diverse national contexts., Conclusion: For reducing cervical cancer incidence and mortality, the readiness of health systems, the reach and effectiveness of new technologies and algorithms for increasing screening and treatment coverage, and the factors that support sustainability of these programmes need to be better understood. Answering these key IR questions could provide actionable guidance for countries seeking to implement the WHO Global Strategy towards cervical cancer elimination., (Copyright © 2021. Published by Elsevier Inc.)

Objectives: With the perspective of prophylactic vaccination against high-risk human papillomavirus (HPV), we analyzed the viral epidemiology of cervical neoplasia in Senegal., Methods: All patients were treated at the Institut Joliot Curie du Cancer in Dakar. HPV genotypes were characterized using a real-time polymerase chain reaction-based approach and sequencing., Results: Histologically, there were 224 invasive carcinomas, 17 high-grade intraepithelial neoplasia (CIN), and five undetermined histologies. Molecular analysis was conclusive in 241 cases. HPV DNA was found in 207/241 (85.9%) cases while 34/241 (14.1%) remained HPV negative. There was one single genotype in 127/207 (61.4%) cases and several in 80/207 (38.6%) corresponding to 308 genotypes identified. Viral genotyping found HPV16 in 175 (56.8%) cases, HPV18 in 45 (14.6%), HPV45 in 40 (13.0%), HPV58 in 35 (11.4%), HPV33 in 6 (2.0%), HPV35 in 3 (1.0%), HPV31 in 2 (0.6%), HPV39 and HPV56 in one (0.3% each)., Conclusion: Our analysis showed that 98.4% of the HPV-positive cases were associated with viral genotypes covered by the 9-valent HPV vaccine. However, 14.1% of cases remained HPV negative. Therefore, prophylactic vaccination using a 9-valent vaccine should dramatically reduce the incidence of HPV-associated neoplasia but the detection and treatment of CIN remain necessary for the optimal prevention of cervical cancer., (© 2021 Wiley Periodicals LLC.)

Purpose: To enable design of optimum palliative care for women with cervical cancer, we studied the most common types of suffering and their severity, prevalence, and duration., Methods: We first reviewed the literature on the major types, severity, prevalence, and duration of suffering associated with cervical cancer. We then conducted a modified Delphi process with experts in cervical cancer care to supplement the literature. For each type of suffering, we distinguished between decedents (those who die from cervical cancer in a given year) and nondecedents (those who have cervical cancer in a given year but do not die). By applying the suffering prevalence and duration estimates to the number of decedents, nondecedents, and family caregivers in 2017, we were able to estimate their palliative care needs and the intensity of palliative care needed to respond adequately to this suffering., Results: There is a high prevalence among decedents of moderate or severe pain (84%), vaginal discharge (66%), vaginal bleeding (61%), and loss of faith (31%). Among both decedents and nondecedents, there is a high prevalence of clinically significant anxiety (63% and 50%, respectively), depressed mood (52% and 38%, respectively), and sexual dysfunction (87% and 83%, respectively). Moderate or severe financial distress is prevalent among decedents, nondecedents, and family caregivers (84%, 74%, and 66%, respectively). More than 40% of decedents and nondecedents are abandoned by their intimate partners. Most patients experience some combination of moderate or severe physical, psychological, social, and spiritual suffering. In total, 258,649 decedents and 2,558,857 nondecedents needed palliative care in 2017, approximately 85% of whom were in low- and middle-income countries where palliative care is rarely accessible., Conclusion: Among women with advanced cervical cancer, suffering is highly prevalent and often severe and multifaceted., Competing Interests: Eric L. KrakauerEmployment: Inform Diagnostics, Foundation Medicine Xiaoxiao KweteEmployment: Yaozhi Co LtdStock and Other Ownership Interests: Expat IncResearch Funding: RochePatents, Royalties, Other Intellectual Property: My husband Patrick Kwete has a granted patent called Personalized Medical Treatment Provision Software (https://patents.google.com/patent/US20130080425A1/en)Travel, Accommodations, Expenses: Expat Inc Annette HasenburgHonoraria: AstraZeneca, Med Update, Pfizer, Roche, StreamedupGmbH, Tesaro, MedConcept, LEO PharmaConsulting or Advisory Role: PharmaMar, Tesaro, Roche, AstraZeneca, LEO Pharma, GlaxoSmithKline/MSDTravel, Accommodations, Expenses: AstraZeneca, MedConcept, Roche, Streamedup!, Tesaro, MedUpdate, Pfizer Cristiana SessaConsulting or Advisory Role: Basilea Ted TrimbleConsulting or Advisory Role: Merck, GlaxoSmithKline, Inovio PharmaceuticalsResearch Funding: Frantz Viral TherapeuticsNo other potential conflicts of interest were reported.

Women with cervical cancer, especially those with advanced disease, appear to experience suffering that is more prevalent, complex, and severe than that caused by other cancers and serious illnesses, and approximately 85% live in low- and middle-income countries where palliative care is rarely accessible. To respond to the highly prevalent and extreme suffering in this vulnerable population, we convened a group of experienced experts in all aspects of care for women with cervical cancer, and from countries of all income levels, to create an essential package of palliative care for cervical cancer (EPPCCC). The EPPCCC consists of a set of interventions, medicines, simple equipment, social supports, and human resources, and is designed to be safe and effective for preventing and relieving all types of suffering associated with cervical cancer. It includes only inexpensive and readily available medicines and equipment, and its use requires only basic training. Thus, the EPPCCC can and should be made accessible everywhere, including for the rural poor. We provide guidance for integrating the EPPCCC into gynecologic and oncologic care at all levels of health care systems, and into primary care, in countries of all income levels., Competing Interests: Eric L. KrakauerEmployment: (I) My wife is employed by Inform Diagnostics and Foundation Medicine Xiaoxiao KweteEmployment: Yaozhi Co LtdStock and Other Ownership Interests: Expat IncResearch Funding: RochePatents, Royalties, Other Intellectual Property: (I) My husband Patrick Kwete has a patent called Personalized Medical Treatment Provision Software (https://patents.google.com/patent/US20130080425A1/en)Travel, Accommodations, Expenses: Expat Inc Shekinah N. ElmoreStock and Other Ownership Interests: TeladocConsulting or Advisory Role: Best Doctors Inc, Wild Type Annette HasenburgHonoraria: AstraZeneca, Med Update, Pfizer, Roche, Streamedup!, Tesaro, MedConcept, LEO PharmaConsulting or Advisory Role: PharmaMar, Tesaro, Roche, AstraZeneca, LEO Pharma, GlaxoSmithKline/MSDTravel, Accommodations, Expenses: AstraZeneca, MedConcept, Roche, Streamedup!, Tesaro, MedUpdate, Pfizer Mihir KamdarLeadership: Amorsa TherapeuticsStock and Other Ownership Interests: Amorsa TherapeuticsConsulting or Advisory Role: Medtronic, Fern Health Cristiana SessaConsulting or Advisory Role: Basilea Ted TrimbleConsulting or Advisory Role: Merck, GlaxoSmithKline, Inovio PharmaceuticalsResearch Funding: Frantz Viral TherapeuticsNo other potential conflicts of interest were reported.

The essential package of palliative care for cervical cancer (EPPCCC), described elsewhere, is designed to be safe and effective for preventing and relieving most suffering associated with cervical cancer and universally accessible. However, it appears that women with cervical cancer, more frequently than patients with other cancers, experience various types of suffering that are refractory to basic palliative care such as what can be provided with the EPPCCC. In particular, relief of refractory pain, vomiting because of bowel obstruction, bleeding, and psychosocial suffering may require additional expertise, medicines, or equipment. Therefore, we convened a group of experienced experts in all aspects of care for women with cervical cancer, and from countries of all income levels, to create an augmented package of palliative care for cervical cancer with which even suffering refractory to the EPPCCC often can be relieved. The package consists of medicines, radiotherapy, surgical procedures, and psycho-oncologic therapies that require advanced or specialized training. Each item in this package should be made accessible whenever the necessary resources and expertise are available., Competing Interests: Eric L. KrakauerEmployment: (I) My wife is employed by Inform Diagnostics and Foundation Medicine Xiaoxiao KweteEmployment: Yaozhi Co LtdStock and Other Ownership Interests: Expat IncResearch Funding: RochePatents, Royalties, Other Intellectual Property: My husband Patrick Kwete has a granted patent called “Personalized Medical Treatment Provision Software” (https://patents.google.com/patent/US20130080425A1/en)Travel, Accommodations, Expenses: Expat Inc Shekinah N. ElmoreStock and Other Ownership Interests: TeladocConsulting or Advisory Role: Best Doctors Inc, Wildtype Annette HasenburgHonoraria: AstraZeneca, Med Update, Pfizer, Roche, Streamedup!, Tesaro, MedConcept, LEO PharmaConsulting or Advisory Role: PharmaMar, Tesaro, Roche, AstraZeneca, LEO Pharma, GlaxoSmithKline/MSDTravel, Accommodations, Expenses: AstraZeneca, MedConcept, Roche, Streamedup!, Tesaro, MedUpdate, Pfizer Mihir KamdarLeadership: Amorsa TherapeuticsStock and Other Ownership Interests: Amorsa TherapeuticsConsulting or Advisory Role: Medtronic, Fern Health Cristiana SessaConsulting or Advisory Role: Basilea Ted TrimbleConsulting or Advisory Role: Merck, GlaxoSmithKline, Inovio PharmaceuticalsResearch Funding: Frantz Viral TherapeuticsNo other potential conflicts of interest were reported.

Objectives: To determine the epidemiological characteristics of patients with squamous cell carcinoma of the cervix, to describe its forms and to assess the treatment they received., Material and Methods: This retrospective study examined records of 616 cervical carcinomas at Dakar Cancer Institute from 1977 to 1999. All cases of squamous cell carcinoma were included, and their epidemiological, clinical and therapeutic aspects described. Five-year survival was calculated by the actuarial method., Results: Patients' mean age was 35 years, and 86% were older than 35 years. Mean parity was 8 and 44.4% of patients had reached menopause. According to the FIGO classification, 419 patients had advanced stage (IIb, III, IV) cancers, and tumours were histologically differentiated in 20.1% of cases. Radical hysterectomies were performed for 252 patients (40.9%). In all, 152 patients (24.67%) received external neoadjuvant radiation therapy and 69 (11.2%) adjuvant radiation therapy. Postoperative complications included urinary fistulas, lymphoceles, and phlebitis. Recurrence was seen in 133 cases and was significantly associated with stage and time until radiation therapy., Conclusion: Curietherapy might improve our treatment of these advanced cervical cancers. Their prevention requires the establishment of facilities for early diagnosis and population screening for detection of precancerous lesions of the cervix. The vaccinal approach recently introduced in developed countries appears to be too costly for developing countries today.

The wertheim complications are dominated by the urinary dysfonction and the lymphocele which are linked at this procedure. This study reported 412 Wertheim associated to the radiotherapy. The purpose was to evaluate the complications among patients who underwent the Wertheim and to analyse the differents factors promotions the complications. The diagnosis was always late and the disease stage was advanced. The stages II, III and IV represented more than 80%. We found 86 complications (20.87%) distributed as follow: 17 urinary (19.76%), 30 secondary infections (34.88%), 8 colonic fistula (9.30%), 7 hemorrage (8.13%), 6 lymphedema (6.97%), 3 occlusions (3.48%), 1 phlebitis (1.16%), 1 lymphocele (1.16%). among all patients, 17 died, the mortality rate was 4.12%. A very good dissection preceded by radiotherapy may reduce the complications rate.

Through a retrospective study of 50 cervix carcinoma during pregnancy, the authors determine the epidemiology, discuss the therapeutic and the pronostic. The mean age of patients were 36 years and the clinical staging of FIGO found : 3 stages Ia, 3 Ib, 7 IIa, 14 IIb, 7 IIIa, 7 IIIb, 4 IVa, 5 IVb The diagnosis of carcinoma was in 6 cases(12%) at first trimester, in 6 cases(12%) at midtrimester, in 13 cases(27%) at third trimester, in 19 cases(28%) after delivery. The termination of pregnancy was an abortion in 6 cases(12%). The treatment was: 29 delivery whose 12 followed bycolpohysterectomy,1 byconisation and 16 had not a colpohysterectomy. 5 cesarean section whose 2 followed by colpohysterectomy in the same time and 3 in the second time. The radiotherapy was neoadjuvant in 3 cases and adjuvant in 3 cases. The mortality was 4 % and the global survival at 5 years was 30%. The prognostic of the cervix carcinoma during pregnancy would get better by Pap test which must be systematic at the pregnant woman.