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This study aimed to design an autodelineation model based on convolutional neural networks for generating high-risk clinical target volumes and organs at risk in image-guided adaptive brachytherapy for cervical cancer. A novel SERes-u-net was trained and tested using CT scans from 98 patients with locally advanced cervical cancer who underwent image-guided adaptive brachytherapy. The Dice similarity coefficient, 95th percentile Hausdorff distance, and clinical assessment were used for evaluation. The mean Dice similarity coefficients of our model were 80.8%, 91.9%, 85.2%, 60.4%, and 82.8% for the high-risk clinical target volumes, bladder, rectum, sigmoid, and bowel loops, respectively. The corresponding 95th percentile Hausdorff distances were 5.23 mm, 4.75 mm, 4.06 mm, 30.0 mm, and 20.5 mm. The evaluation results revealed that 99.3% of the convolutional neural networks-generated high-risk clinical target volumes slices were acceptable for oncologist A and 100% for oncologist B. Most segmentations of the organs at risk were clinically acceptable, except for the 25% sigmoid, which required significant revision in the opinion of oncologist A. There was a significant difference in the clinical evaluation of convolutional neural networks-generated high-risk clinical target volumes between the two oncologists (P < 0.001), whereas the score differences of the organs at risk were not significant between the two oncologists. In the consistency evaluation, a large discrepancy was observed between senior and junior clinicians. About 40% of SERes-u-net-generated contours were thought to be better by junior clinicians. The high-risk clinical target volumes and organs at risk of cervical cancer generated by the proposed convolutional neural networks model can be used clinically, potentially improving segmentation consistency and efficiency of contouring in image-guided adaptive brachytherapy workflow. [ABSTRACT FROM AUTHOR]

Résumé Introduction-: Le cancer du col de l’utérus fait partie de principales causes de dé­cès des femmes dans le monde. Il affecte de façon considérable la santé tant phy­sique que mentale. L’objectif de ce travail était d’évaluer la perception du cancer de col de l’utérus chez les étudiantes de l’Université de Kinshasa Matériels et méthodes -La méthode d’enquête a été utilisée pour évaluer la perception du cancer du col de l’Utérus. Elle a été appuyée par un questionnaire d’enquête qui s’est inspiré de celui de Cissé 2012 et du baromètre cancer 2015 de l’Institut Français de Cancer. Ce questionnaire a été administré à un échantillon non-probabiliste de 105 étudiantes finalistes des premier et deuxième cycles de quelques facultés de l’Université de Kinshasa. Résultats -Les résultats renseignent que les étudiantes sous-étude ont une perception positive du cancer du col de l’utérus. Cette perception positive se manifeste par la pré­dominance des connaissances objectives que subjectives relatives au cancer de col de l’utérus et à ses facteurs de risque. Pour ces sujets, le cancer de col de l’utérus est une maladie plus grave et plus mortelle que toutes les autres maladies (SIDA, malaria…). Ils affirment, à cet effet, que les conséquences physiques (mort, stérilité) sont plus graves que toutes les autres conséquences du cancer. C’est pourquoi, ils pensent que le dépis­tage précoce protège contre la survenue et les effets de ce cancer. Conclusion -Le cancer du col de l’utérus est perçu positivement par les sujets enquêtés. Cette perception positive peut conduire les enquêtés à éviter des conduites à risque et à se faire dépister précocement, et cela, à titre préventif. Abstract Background-: Cervical cancer is one of the leading causes is one of the leading causes of death among women worldwide. It significantly both physical and mental health. The aim of this study was to evaluate the perception of cervical cancer among female students at the University of Kinshasa Methods - Survey method was used to assess the perception of cervical cancer. It was sup­ported by a survey questionnaire inspired by that of Cissé 2012 and the InstitutFrançais de Cancer’s 2015 cancer barometer. It was administered to a non-probabilistic sample of 105 female undergraduate and graduate finalists from faculties of the University of Kinshasa. Results -The results show that students have a positive perception of cervical cancer. This positive perception is reflected in the predominance of objective subjective knowledge of cervical cancer and its risk factors. For these subjects, cervical cancer is a more serious and deadly disease than any other (AIDS, malaria...). They claim that the physical consequences (death, sterility) are more serious than all the other consequences of cancer. Conclusion -Cervical cancer is perceived positively by the subjects surveyed. This posi­tive perception may lead respondents to avoid risky behavior and undergo early scree­ning as a preventive measure.

Background: About 99.7% of cervical dysplasia and cancer cases are caused by persistent genital high-risk human papillomavirus (hrHPV) infection. Most HPV infections are subclinical and self-limiting but may persists in about 5 to 10% of infected women, resulting in pre-cancerous lesions that can progress to invasive cancer years later. This study is aimed at detecting hrHPV among apparently healthy women of reproductive age in Kaduna State, thus providing more information for effective control of HPV and cervical cancer in Nigeria. Methodology: Cervical smears were taken from 515 randomly selected apparently healthy women across selected secondary and tertiary facilities from 3 Local Government Areas (LGAs) in each Senatorial Zone of Kaduna State, Nigeria. Liquid-based cytology (LBC) technique was used to collect cervical smears and prepare smears for cytology study, while the remaining samples were stored at -80oC for molecular studies. HPV DNA were extracted from the samples and amplified by convectional PCR using specific hrHPV (HPV 16,18,31 and 45) primer sets and a broad spectrum MY09/11 and GP5+/6+ primers for a wider range of HPV genotypes. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 23.0 and relationship between prevalence of hrHPV and socio-demographic factors such as age and marital status were determined using Chisquare or Fisher Exact test with p<0.05 considered statistically significant. Results: The prevalence of total HPV and hrHPV infections in the study population was 11.8% (61/515) and 9.3% (48/515) respectively. A total of 100 HPV genotypes were detected by PCR in the 61 positive smears, with 66 hrHPV types from 48 women, and 34 other HPV types from 13 women. The frequency of hrHPV genotypes detected was HPV 31 (5.8%, n=30), HPV 45 (4.1%, n=21), HPV 16 (1.7%, n=9), and HPV 18 (1.2%, n=6), with other HPV genotypes (6.6%, n=34). The frequency of cervical dysplasia was 6.4% (33/515), which was significantly associated with all HPV genotypes except HPV 16. Single HPV infection was seen in 31 (51.8%) women while multiple infections were seen in 30 (49.2%), with double infection in 21 (34.4%) and triple infections in 9 (14.7%). Conclusion: The prevalence of hrHPV infection was high among women in Kaduna State, Nigeria. DNA-based screening for hrHPV genotypes and production of new vaccine that will protect against the predominant hrHPV genotypes are thus recommended for the prevention of cervical cancer in Nigeria, Africa and beyond. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Studies on genital mycoplasmas (GM) role in gynaecologic cancers (GC) such as cervical, endometrial, ovarian, vaginal, vulva and fallopian tube, is limited. This review was conducted to evaluate an association between GM and GC. The systematic study was conducted in accordance with PRISMA guidelines across online databases including Embase, Google Scholar, PubMed, Scopus, and Web of Science from inception to August, 2022. We included crosssectional and case-control studies examining possible connection of GM infection and development of GC, and all evidence-based studies with likely association between GM infection and incidence of GC were studied. Selection criteria aided identification, screening, and risk of bias assessment. Thirteen studies with at least moderate risk of bias, were included. The most commonly associated GMs was Mycoplasma genitalium followed by Ureaplasma urealyticum and Mycoplasma hominis. Studies reported disease advancement with GMs most especially in cases of co-infection. The most associated GCs were cervical, ovarian and endometrial. Infection with U. urealyticum, M. hominis, and M. genitalium was associated with cervical cancer risk (OR 1.31-1.41), and M. hominis and M. genitalium had associated risk with ovarian (RR 0.93-1.92) and endometrial cancer (OR 1.36-2.07). No association was found with vaginal, vulva and fallopian tube cancers. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Since the introduction of HPV testing as a first-line screening method for women aged 30 and over, vaginal sampling (VS) by a healthcare professional or self-sampling (SS) is now possible for women who have not responded to the organized screening program using cervical uterine sampling. The aim of this study was to understand the choices made by a sample of women from La Reunion would like to perform their VS, and the content of the instructions they would like to receive., Methods: We conducted a cross-sectional descriptive study using a single-answer questionnaire. Patients were either interviewed in doctors' office or offered the possibility to answer an online questionnaire. We included women aged 30 to 65 in La Reunion who were concerned by CC screening. We compared the answers of women who were up to date with their screening with those of women who were not., Results: We included 202 women. The study showed that 64.9% of patients wished to collect the VS kit from a healthcare professional, 80.8% wished to perform SS and 52.5% wished to return it to the laboratory. The preferred language of the instruction was French, with pictures and drawings for 48.5% of patients. There was no significant difference between the answers of women who were up to date with their screening and those who were not., Conclusion: In a sample of women eligible for CC screening in La Reunion, the preferred methods for CC screening were to collect the PV kit from a healthcare professional, perform the SS at home and then return it to the laboratory. These responses differed from other studies. A feasibility study on a part of La Reunion's eligible population for CC screening would enable us to assess the feasibility and generalizability of a screening modality based on SS., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: cervical cancer is a public health problem in Cameroon, ranking as the 2nd most frequent cancer. The purpose of our study was to describe the epidemiological and clinical characteristics of patients with cervical cancer at the Douala General Hospital in Cameroon. Method: we conducted a retrospective study over the period 1 January 2016 to 31 December 2017. Results: the study enrolled 357 women. Patients' age ranged from 25 to 88 years, with an average age of 52.82 ± 12.36 years. Patients from the Western Region were more heavily represented, with a percentage of 42.2% (n= 124/294). The majority of them were unemployed housekeepers (57.3%; n=200/341). The age of first sexual intercourse was recorded for only 37% (n=133/357) of the study population, with an average age of 16.73 ± 2.16 years; while the average age on giving birth to the first child was 18.92 ± 3.44 years. On the other hand, 6.5% (n=11/169) of patients were smokers, while 44% (n=73/166) were alcohol abusers. Squamous cell carcinoma was the most common histologic type (85.6%; n=255/298). The most frequent stage at diagnosis was stage IIB (22.3%, n=71/319) followed by stage IIIB (21.6%; n=69/319). Conclusion: in Cameroon, cervical cancer commonly occurs in unemployed adult women and it is associated with an advanced-stage diagnosis. Hence the need to improve awareness of prevention and early diagnosis. [ABSTRACT FROM AUTHOR]

Les papillomavirus humains responsables du cancer du col de l'utérus ont été identifiés au début des années 1980. Le rôle causal de certains de ces virus a été confirmé par plusieurs études épidémiologiques, et au début des années 1990 des vaccins constitués de la protéine majeure de la capside virale ont montré leur efficacité dans des modèles animaux de papillomavirus. Ces résultats ont rendu possible le développement de vaccins contre le cancer du col de l'utérus et d'autres cancers induits par les papillomavirus génitaux. Cette revue présente les données récentes concernant l'efficacité des vaccins contre les papillomavirus. Les premiers résultats obtenus lors de grandes études randomisées ont conduit, à partir de 2006, à la commercialisation de quatre vaccins. Depuis, de nombreuses études ont confirmé la très grande innocuité et la remarquable efficacité de ces vaccins contre les lésions pré-cancéreuses associées aux différents cancers induits par les papillomavirus. Même si les vaccins contre les papillomavirus se sont montrés très efficaces et d'une grande sûreté, l'extension de la vaccination contre les papillomavirus se heurte à l'hésitation de la population et à la désinformation concernant son innocuité conduisant dans certains pays, dont la France, à une couverture vaccinale très insuffisante. Plus récemment, l'efficacité de la vaccination contre les papillomavirus génitaux dans la prévention du cancer du col de l'utérus a été démontrée en Suède et au Royaume-Uni. The human papillomaviruses associated with cervical cancer were identified in the early 1980s. Epidemiological confirmation of their causal role, and finally the demonstration in the early 1990s that the major capsid protein, self-assembled in virus-like particles, provides protection against infection in papillomavirus animal models, have made possible the development of vaccines against cervical cancer as other HPV-associated cancers. In this article, we review the knowledge concerning HPV vaccines and vaccination including the last development. The efficacy of vaccines against human genital papillomavirus has been demonstrated in large randomized trials, and the safety and efficacy results obtained led, between 2006 and 2020, to the marketing of four vaccines. Numerous studies have since confirmed the very high safety and remarkable effectiveness of these vaccines in the prevention of pre-cancerous lesions associated with the various cancers induced by papillomaviruses. Although human papillomavirus vaccines are very effective and very safe vaccines, the extension of the vaccination against papillomaviruses comes up against the hesitation of the population and misinformation concerning its safety leading in some countries, including France, to highly insufficient vaccination coverage. Recently, the effectiveness of national vaccination programs against cervical cancer has been reported in Sweden and the United Kingdom. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The 5-fraction scheme (5 × 5–5.5 Gy) is a common High-Dose Rate (HDR) intracavitary brachytherapy regimen for locally advanced cervical cancer (LACC). Yet, its equivalence with Pulse-Dose rate (PDR) schemes remains unproved. The present study aimed at reporting on the outcome of LACC patients treated with 5-fraction HDR brachytherapy. The medical records of all consecutive patients treated with curative-intent HDR brachytherapy for a LACC in a French Cancer Center were retrospectively reviewed. Thirty-eight LACC patients underwent a 5-fraction intracavitary HDR brachytherapy between 2015 and 2019 (median dose = 25 Gy/5 fractions, following external-beam radiotherapy). Median age at diagnosis was 60 (range: 29–87). Thirty-one patients (81.5%) underwent concurrent chemotherapy. Tumor stages ranged from 3 IB2 (7.8%), 4 IB3 (10.5%), 4 IIA2 (10.5%), 12 IIB (31.7%), 1 IIIA (2.6%), 2 IIIB (5.3%), 7 IIIC1 (18.5%), 4 IIIC2 (10.5%), 1 IVA (2.6%) (2018 FIGO). Median D90% to CTV HR reached 79.5 Gy (EQD2). Median D90% to CTV IR reached 59.5 Gy (EQD2). Median Bladder D2cc was 69.8 Gy (EQD2). Median Rectum D2cc was 58.3 Gy (EQD2). Acute/late grade 3 toxicity was reported in one patient (2.6%). No grade 4–5 toxicity occurred. At a median 38 months follow-up, 10 patients (26.3%) had local (n = 7, 18.4%), nodal (n = 6, 15.7%) and/or distant (n = 7, 18.4%) relapse. Three-year overall survival rate was of 81.6%. The 5-fraction HDR scheme was well tolerated even in frail patients. Three-year local control was lower than expected. Treatment (absence of parametrial interstitial implants and use of cervical EBRT boost) and patients' characteristics (age, comorbidities) may explain such results. [ABSTRACT FROM AUTHOR]

L'infection au papillomavirus humain (HPV) représente une des infections sexuellement transmissibles les plus répandues dans le monde et le principal agent causal dans le développement du cancer du col de l'utérus. Certains facteurs de risque, notamment l'immunodépression favorisent la persistance et la progression des lésions cervicales vers des lésions intra-épithéliales agressives. Les patientes souffrant de pathologies auto-immunes comme le lupus érythémateux systémique seraient plus vulnérables aux infections à HPV et à un risque accru de progression vers une dysplasie cervicale. Les facteurs de risque de développer une infection persistante à HPV puis une dysplasie ne sont pour autant pas identifiés dans le lupus. L'existence d'un excès de risque de cancer du col par rapport à la population générale reste débattue. Ainsi, le vaccin est recommandé chez les jeunes patients lupiques au même titre que dans la population générale. La couverture vaccinale contre l'HPV chez les lupiques n'est pas précisément connue. Il semble que la couverture vaccinale générale des malades chroniques est insuffisante compte tenu de leur fragilité vis-à-vis du risque infectieux. Des stratégies sont à mettre en place pour lever les barrières à la vaccination. Infection with human papillomavirus (HPV) is one of the most widespread sexually transmitted diseases and the main risk factor for cervical cancer. Underlying conditions, like immunosuppression, favour the persistence and the progression of cervical lesions to an aggressive form. Patients with autoimmune diseases, and particularly systemic lupus erythematosus (SLE), may be prone to HPV infection and cervical dysplasia. However, the risk factors for developing persistent HPV-related infection, dysplasia and cancer are not identified for patients with SLE. The existence of an increased risk of cervical cancer compared to the general population remains debated. Thus, HPV vaccine is recommended for SLE patients as well as for the general population. Vaccine coverage of SLE patients is not known in France. Adolescents with chronic health condition seem to be insufficiently vaccinated regarding their vulnerability to infectious diseases. Strategies are required to decrease HPV vaccination barriers. [ABSTRACT FROM AUTHOR]

Background: Many women are known to contract human papilloma virus (HPV) infection in their lifetime but only a few develop cervical cancer. One of the major factors that contribute to development of cervical cancer is HPV persistence. Several other factors including viral load have been implicated in cervical cancer development. This work therefore intends to investigate the persistence of cervical HPV infection among cohort of women in Awka, Nigeria. Methodology: A cohort of 58 women with normal Papanicolaou (Pap) test but positive HPV DNA selected from a population of 410 women at baseline were followed up over a period of 6 months from April to October 2015. Cervical specimens collected were subjected to HPV DNA test and viral quantification using TaqMan Real Time PCR and cervical cytology. Risk factors were obtained using semi structured interviewer administered questionnaires. Variables were analysed using descriptive statistics and T-test on IBM SPSS statistics version 21.0 and EPI INFOTM 7.0 Results: At the 6-month follow up, cervical HPV infection persisted in 29 women, representing 50% of the women followed up. Among the 29 women, 7 (24.1%) developed abnormal Pap smear (Low grade Squamous Intraepithelial Lesion). Factors significantly associated with persistence at bivariate analysis of HPV include previous sexually transmitted infection (STI) (p=0.005), HIV positivity (p=0.04), HIV positivity but no anti-retroviral drugs (p=0.014), HPV 16 infection (p<0.0001) and age less than 40 years (p<0.0001). At multinomial logistic regression, only age above 17 years at first sexual intercourse (p=0.003, CI=0.012-0.392) and multiple lifetime sexual partners (p=0.021, CI=0.20-0.726) were statistically significant. Conclusion: High risk HPV infection, in addition to other factors peculiar to an individual may influence HPV persistence. [ABSTRACT FROM AUTHOR]

Les papillomavirus humains (HPV) sont des pathogènes cutanéo-muqueux. Ils sont en particulier responsables de lésions bénignes ou malignes des muqueuses anogénitales et oropharyngées, dont l'une des formes les plus prévalentes est le cancer du col de l'utérus, lié à l'infection persistante par un HPV à haut risque (HPV-HR). En France, de récentes modifications ont été apportées dans le dépistage du cancer du col de l'utérus, avec l'introduction du test virologique de détection des HPV-HR chez les femmes âgées de 30 à 65 ans. L'autre volet de la prévention des cancers du col de l'utérus et d'une partie des pathologies HPV-induites repose sur la vaccination, désormais recommandée à l'adolescence à la fois chez les filles et les garçons, à l'aide du vaccin nonavalent. Pour l'enfant plus jeune, si les HPV sont avant tout impliqués dans des verrues cutanées, il ne faut pas méconnaître la possibilité d'atteintes muqueuses ou de formes infectieuses associées à des maladies génétiques. Human Papillomaviruses (HPV) are pathogens infecting skin and mucosa. HPV are responsible for benign or malignant mucosal lesions, mostly at the anogenital and oropharyngeal sites. The most prevalent HPV-induced cancer is cervical cancer, associated to a persistent infection by a high-risk HPV (HR-HPV). In France, the strategy of cervical cancer screening has changed recently, with the introduction of HR-HPV testing for women aged 30 to 65 years. In order to better prevent HPV-associated diseases, vaccine recommendation has been extended to teenage boys. For young children, warts are the most frequent manifestations of HPV infections, although some mucosal infections and specific HPV diseases in a context of genetic disorders may also occur. [ABSTRACT FROM AUTHOR]

This study aimed to compare the absolute numbers of various types of lymphocytes in the peripheral blood before and after chemotherapy following radio-chemotherapy in patients with cervical cancer, so as to explore the correlation between the changes in the absolute numbers of peripheral various types of lymphocytes and the overall survival rate of patients. Data of 205 patients with cervical cancer admitted to the hospital from June 2014 to August 2016 were retrospectively analyzed. These patients underwent concurrent radio-chemotherapy, followed by chemotherapy. The absolute numbers of peripheral blood lymphocytes and subtypes were compared before and after re-chemotherapy. For patients with a good prognosis, the number of lymphocytes, T cells, and cytotoxic T cells (Tc) significantly decreased (P < 0.05) after re-chemotherapy, while this phenomenon was not observed in patients with poor prognosis. Kaplan–Meier univariate analysis showed that patients with cervical cancer who had an advanced FIGO stage before treatment, presence of lymph node metastasis, and increased numbers of Tc and T helper cells after re-chemotherapy showed a low 30-month survival rate; the overall log-rank analysis showed significant differences (P < 0.05). Multivariate Cox proportional hazards regression analysis, presence of lymph node metastasis: HR = 9.718, P = 0.002, 95% CI = 0.183–0.679; Tc grouping: HR = 3.239, P = 0.0.072, 95% CI = 0.950–03.347; Th group: HR = 3.197, P = 0.074, 95% CI = 0.943–3.564. After radio-chemotherapy, in patients with advanced cervical cancer, the change in the numbers of peripheral blood Tc and Th before and after re-chemotherapy was associated with the 30-month overall survival rate of patients. It can be considered as a predictor of the survival of patients with advanced cervical cancer. [ABSTRACT FROM AUTHOR]

• This article focuses on a topical issue in France: vaccination against papillomavirus. We performed a qualitative study using grounded theory until data saturation, to assess the perceptions of young girls regarding the anti-HPV vaccine. Their opinion of anti-HPV vaccination was not negative, but we observed a clear lack of knowledge as well as misbeliefs. Family physicians are key to promoting this vaccination. Cervical cancer can be avoided with smear screening, and since 2006 with vaccination against papillomavirus. Yet, vaccination coverage remains very low in France. We aimed to highlight the perceptions and feelings of young girls regarding papillomavirus vaccination, to initiate a discussion and find ways to promote this vaccination. Qualitative study with semi-directed interviews, until data saturation, and using grounded theory, with volunteer girls aged 11–14 years in a French department from September to December 2016. Thirty-four young girls were interviewed. Their opinion of anti-HPV vaccination was not negative. Knowledge of papillomavirus vaccination was better in those aged above 12 years, in urban areas, and in those vaccinated against hepatitis B. Young girls with parents working in the medical field seemed to be more involved in the vaccination process. Nevertheless, we observed a clear lack of knowledge or misbeliefs. Parents, especially mothers, were the most important source of information for girls. Family physicians played an essential role in the vaccination decision-making process. Girls seem to be barely involved in the vaccination process. However, this vaccination is based on the young girl/parents/physician trio. All healthcare professionals should be trained so as to have a scientifically valid speech on vaccination. Family physicians play a central part. Comprehensive and adequate information should be provided to girls and parents. [ABSTRACT FROM AUTHOR]

L'infection par le virus du papillome humain (HPV), transmise par voie sexuelle, peut entraîner des condylomes mais elle est également impliquée dans la très grande majorité des cancers du col de l'utérus. La stratégie globale de prévention repose sur la vaccination anti-HPV et le dépistage. Human papillomavirus (HPV) infection, transmitted sexually, can cause condylomas but is also involved in the vast majority of cervical cancers. The overall prevention strategy is based on HPV vaccination and screening. [ABSTRACT FROM AUTHOR]

Les papillomavirus humains (HPV) sont des pathogènes cutanéo-muqueux fréquents, à l'origine de lésions bénignes et malignes, telles que des condylomes anogénitaux et des cancers du col de l'utérus. Ces deux dernières années ont été marquées par d'importantes avancées dans la prévention des pathologies induites par les HPV avec, en particulier, l'introduction de la recommandation vaccinale pour les jeunes garçons et la recherche du génome viral des HPV à haut risque en première ligne du dépistage des cancers du col de l'utérus chez les femmes âgées de 30 à 65 ans. Human papillomaviruses (HPV) are common mucocutaneous pathogens that cause benign and malignant lesions such as anogenital condyloma and cervical cancer. The last two years have seen important advances in the prevention of HPV-induced pathologies with, in particular, the introduction of the vaccine recommendation for young boys and the search for the viral genome of high-risk HPVs in the first line of screening for cervical cancers in women aged 30 to 65 years. [ABSTRACT FROM AUTHOR]

Objectives: Describing the constitution of the FRANCOGYN group (a national French research group in Oncological and Gynecological Surgery) and present its current and future development., Methods: Literature review using PUBMed database with the keyword "FRANCOGYN"., Objectives: Describing the constitution of the FRANCOGYN group (a national French research group in Oncological and Gynecological Surgery) and present its current and future development., Results: The FRANCOGYN group was formed in December 2015, bringing together over the years more than 17 gynecological and oncological surgical department in France. The group carries out clinical research on gynecological pelvic cancers by constituting retrospective cohorts. Its legitimacy allows it to lead or co-lead the drafting of recommendations for clinical practice in the field of gynecological cancers. It now offers prospective randomized research funded by national grants., Conclusion: The FRANCOGYN network allows us to propose a national reflection on the surgical management of pelvic cancers in women, resulting in numerous international reference publications., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

• Des préoccupations ont été soulevées concernant la relation entre les traitements de la goutte et le risque de cancer. • Malgré l'absence de preuves épidémiologiques, cette étude montre une association entre les traitements de la goutte et le risque de cancer. • Les médicaments antigoutteux augmentent de manière significative le risque des cancers les plus courants, en particulier la leucémie, le lymphome non hodgkinien, le cancer de l'endomètre, du sein et du col de l'utérus. Objectif Aucune conclusion définitive n'a été tirée à ce jour concernant le risque de cancer lié aux traitements de la goutte administrés à court et long terme. Cette étude avait pour objectif d'évaluer l'association entre l'utilisation des traitements antigoutteux et le risque de cancer. Nous avons mené une étude rétrospective longitudinale cas-témoins basée sur la population à Taïwan. Tous les patients âgés de 20 ans et plus, ayant reçu un premier diagnostic de cancer entre 2001 et 2011 ont été inclus dans cette étude. Les valeurs des odds ratio ajustés (ORa) et de leurs intervalles de confiance (IC) à 95 % ont été calculées par régression logistique conditionnelle. Nous avons analysé 601 733 cas et 2 406 932 témoins appariés. L' odd ratio ajusté pour l'utilisation des traitements antigoutteux et le risque global de cancer était de 1,007 (IC 95 %, 0,994–1,020). Il existait un risque significatif de leucémie (ORa : 1,34, IC 95 % : 1,20–1,50), de cancer de l'endomètre (ORa : 1,33, IC 95 % 1,12–1,57), de lymphome non hodgkinien (ORa : 1,24, IC 95 % : 1,13–1,35), de cancer du sein féminin (ORa : 1,21, IC 95 % : 1,13–1,29) et de cancer du col de l'utérus (ORa : 1,21, IC 95 % : 1,07–1,37). Cependant, aucune association n'a été observée dans le groupe des hommes (ORa : 0,97, IC 95 % : 0,95–0,98) mais un risque accru de cancer, tous sites confondus, a été retrouvé chez les femmes (ORa : 1,107, IC 95 % : 1,08–1,13). En résumé, nos résultats suggèrent que les traitements de la goutte augmentent le risque de survenue des cancers les plus courants, en particulier la leucémie, le lymphome non hodgkinien, le cancer de l'endomètre, du sein et du col de l'utérus. [ABSTRACT FROM AUTHOR]

Abstract Purpose The aim of the present study was to identify management strategies and outcomes of patients with stage IB1 cervical cancer with high recurrence risk. Materials and methods Medical files of all consecutive patients treated between 2004 and 2017 with external beam radiotherapy and/or brachytherapy for IB1 cervical cancer, whatever the lymph node status, were retrospectively reviewed. Results Forty-two patients were included, with a median age of 49.8 years old. Median tumour size, estimated with the initial pelvic magnetic resonance imaging, was 26 mm (interquartile range [IQR] = 19.5–35). Histological types were mainly squamous cell carcinoma (59.5%) and adenocarcinoma (33.3%). Lymphovascular invasion was reported for 38.1% of patients. Pelvic lymph nodes were involved for eight patients (19.0%). Surgery was performed for 39 patients (92.9%). A neoadjuvant treatment was delivered for 20 patients (47.6%), an adjuvant treatment for 19 patients (45.2%) and an exclusive radiotherapy (with or without chemotherapy) followed by brachytherapy for three patients (7.1%). Pathologic complete response was achieved in 61.5% of patients. With a median follow-up of 5.8 years (IQR = 2.6–9.4), five patients (11.9%) experienced a tumour relapse. The five-year disease-free survival was 79.5% (95% confident interval [CI] = 66.9–94.4), the five-year overall survival was 87.8% (95% CI = 77.2–99.8), and the five-year disease-specific survival was 94.2% (95% CI = 86.7–100). Conclusion In current clinical practice, tailored treatments are delivered, and seems to give correct therapeutic index. However, clinical trials are needed to standardise treatment according to patient characteristics and recurrence risk factors. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer (CC) patients receiving indwelling catheterization after radical hysterectomy (RH) are vulnerable to urinary tract infection (UTI). However, no model or method is available to predict the risk of UTIs. Therefore, our aim was to develop and verify a risk model to predict UTI for patients receiving indwelling catheterization after radical cervical cancer surgery (ICa-RCCS)., Methods: We first collected clinical information of 380 patients receiving ICa-RCCS from January 2020 to December 2021 as a training cohort to develop the risk nomogram. UTI was then evaluated using 19 UTI predictor factors. The least absolute shrinkage and selection operator (LASSO) method was utilized for the extraction characteristics. Multivariable logistic regression analysis was then conducted to create the risk model for UTI prediction. The consistency coefficient and calibration curve were utilized to assess the model's fit accuracy. We performed bootstrapping with 1000 random samples for internal validation of the model, and decision curve analysis (DCA) for clinical application., Results: Predictors in the risk nomogram included indwelling catheterization duration, whether it is secondary indwelling catheterization, history of UTIs, age, and history of chemotherapy before surgery. The risk nomogram presented good discrimination and calibration (C-index: 0.810, 95% CI: 0.759-0.861). During interval validation, the model reached a high C-index up to 0.7930. DCA revealed the clinical utility of predictive model for UTI. Clinical benefit was initiated at the decision threshold≥3%., Conclusion: We developed a novel UTI nomogram incorporating the age, history of chemotherapy before surgery, indwelling catheterization duration, whether it is secondary indwelling catheterization, and history of UTI to predict UTI risk for patients receiving ICa-RCCS., Level of Evidence: B: 3a., (Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Objective: To ascertain the level of awareness and attitudes towards cervical cancer among secondary school students in Nigeria.Method: Cross-sectional survey of 432 female senior secondary school students in south-eastern Nigeria.Results: A total of 321 (74.3%) responses were valid; 42.7% had heard of cervical cancer, 32.8% of screening, 23.2% of Pap smears and 22.0% of HPV/HPV vaccinations. No widely available reliable source of information exists. General knowledge about Pap smears (41.8%) and HPV (43.1%) was poor, as was specific knowledge about their benefits, timing and frequency, and about HPV vaccinations, but associated attitudes were moderately positive at 60.2% and 65.1%, respectively. Awareness of cervical cancers increases knowledge about when to start screening (OR = 2.30; P = 0.02) and about early symptoms of cervical cancer (OR = 2.56; P = 0.001).Conclusion: Overall knowledge of cervical cancer is poor, but attitudes are positive. Awareness campaigns are therefore necessary, and are expected to be effective. Campaigns should target teenage females, and commencing teaching in high schools of developing countries, through materials included in their academic curricula, is recommended. [ABSTRACT FROM AUTHOR]

Résumé Le dépistage du cancer du col utérin, basé sur le frottis cervico-vaginal, a été mis en place dans les années 60 dans la plupart des pays développés, permettant une diminution spectaculaire du nombre de cancers. Cependant ce dépistage, proposé en France aux femmes de 25 à 65 ans, ne couvre pas la totalité de la population cible puisque 40 % environ des femmes y échappe dans notre pays. Une alternative pour augmenter la couverture du dépistage est de proposer aux femmes un auto-prélèvement, vaginal ou urinaire, puis un test de détection des papillomavirus humains (HPV). De nombreuses publications ont montré que cette approche présentait une bonne sensibilité et bonne spécificité comparée au frottis pour la détection des lésions histologiques de haut grade. Plusieurs facteurs doivent être validés avant la mise en place à grande échelle de l’auto-prélèvement : le type de dispositif utilisé, la technique de détection des HPV, les modalités de mise à disposition et de retour des dispositifs, l’information des femmes, la prise en charge des femmes avec test HPV positif et, comme pour tout dépistage, le coût/bénéfice de l’approche choisie. Plusieurs études sur l’auto-prélèvement ont été faites en France ces dernières années et cette approche sera certainement intégrée au dépistage organisé du cancer du col utérin prévu dès 2018 pour améliorer l’efficacité de ce dépistage. Self-collection for HPV testing: a new strategy to improve cervical screening coverage? In many developed countries, implementation of cervical cancer screening programs in the sixties based on cervical cytology (Pap-smear) led to a dramatic decrease in the incidence of cervical cancer. However, a significant proportion of women (40% in France) do not attend to regular cervical cancer screening. Self-collection (vaginal or based on urine sample) for HPV DNA testing is a promising approach to increase the coverage of screening. Numerous publications have validated this approach showing high sensitivity and specificity as compared to cervical cytology for the detection of high grade cervical lesions. Some pre-requisite must be validated before implementing self-collection as large scale programs, such as the collection device for self-sampling, the HPV detecting test, the scenario of invitation and kit return, the information delivered, the follow-up of women with positive HPV test and the cost/benefit of the selected strategy. Several programs based on self-collection with HPV testing have been described in France showing promising results. This approach will certainly be part of the future national program of cervical cancer screening, which will be starting in France in 2018. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tumor Necrosis Factor (TNF) plays an essential role in various inflammatory, immune and cancerous processes. TNF-inhibitors have been widely used to treat inflammatory diseases. Infections is the most common side effect of these biological drugs. Conflicting data exist on the risk of cancer following anti-TNFα therapy. Furthermore, the percentage of women with inflammatory disease is rather high. Thus, this study focused on the gynecological side effects of TNF-inhibitors. [ABSTRACT FROM AUTHOR]

Targeting mitochondria is an attractive strategy for cancer therapy due to the essential roles of mitochondria in cancer cell energy metabolism. In this study, we show that mefloquine, an antibiotic drug, effectively targets cervical cancer cells through impairing mitochondrial function. Mefloquine dose-dependently induces apoptosis and inhibits proliferation and anchorage-independent colony formation of multiple cervical cancer cell lines. Mefloquine alone inhibits cervical tumor growth in vivo and its combination with paclitaxel is synergistic in inhibiting tumor growth. Mechanistically, mefloquine inhibits mitochondrial function via inhibiting mitochondrial respiration, decreasing membrane potential, increasing ROS generation, and decreasing ATP level. We further show that mefloquine suppresses activation of mTOR signaling pathway in HeLa cells. However, the inhibitory effects of mefloquine on survival, colony formation, and ATP are abolished in mitochondrial respiration-deficient HeLa ρ0 cells, demonstrating that mefloquine acts on cervical cancer cells via targeting mitochondrial respiration. Inhibition of mTOR signaling pathway by mefloquine was also reversed in HeLa ρ0 cells, suggesting deactivation of mTOR pathway as a consequence of mitochondria function disruption. Our work suggests that mefloquine is a potential candidate for cervical cancer treatment. Our work also highlights the therapeutic value of anti-mitochondria and establishes the association of mitochondrial function and the activation of mTOR signaling pathway in cervical cancer cells. [ABSTRACT FROM AUTHOR]

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Objectives: A nationwide screening program for cervical cancer (CC) was organized in 2018 as part of the 2014-2019 French cancer plan, with the objective of reducing CC incidence and mortality in France by reaching an 80 % coverage rate. As an alternative to pap smear, vaginal self-sampling (VSS) aimed at identifying high-risk HPV carriage could help to achieve this goal. The objective of the present study is to compare the respective budgetary impacts of several self-sampling strategies., Method: A budget impact model was developed to compare non-use of self-sampling in CC screening to the 5-year costs of 5 VSS strategies viewed from an all-payer perspective. While the first strategy was based on mailing the VSS kit with a reminder to participate in the screening program, the second was based on accompanying the mailed kit with an invitation to participate. The third and fourth strategies were based on providing health professionals with the kit, and thereby offering self-sampling as an alternative to pap smears for women undergoing CC screening and having previously received the kits. Finally, the fifth strategy was based on self-sampling as the one and only CC screening modality. The parameters of the model were based on past screening participation data and experiments in France on organized screening and VSS use. The costs included those of procedures associated with screening and program organization., Results: All in all, the costs associated with cervical cancer screening would represent approximately 1 billion euros over 5 years. All strategies would be associated with participation ranging from 81% to 84%, which would represent an increase of 4.7% to 5.2% of lesions diagnosed by screening and a cost reduction between €30M and €87M over 5 years, with the exception of the strategy based on sending the kit (with the reminder associated or not) to the health professionals offering this option (+€23M and +€6M)., Conclusions: In conclusion, the use of self-sampling as an alternative to pap smears for non-participating women would increase participation, with only a moderate budgetary impact and could, in some cases, even induce savings., Competing Interests: Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)