Endometriosis is defined as the presence of viable endometrial glands and stroma outside of the uterus. It is a common disease, occurring in 5 to 15% of all women. Endometriosis is associated with chronic pelvic pain and infertility and often requires surgical intervention for definitive treatment. Although it is a benign gynecologic condition, endometriosis shares pathophysiologic features with cancer. In recent years, both histologic and epidemiologic evidence has accumulated, suggesting that ovarian endometriosis may give rise to malignant ovarian tumors, primarily those that are epithelial in origin, known as endometriosis-associated ovarian carcinoma (EAOC) including ovarian clear cell carcinoma, endometrioid carcinoma, and the least common, seromucinous tumors. Women with endometriosis have a two- to threefold increase in absolute risk of developing epithelial ovarian cancer, especially clear cell and endometrioid subtypes. Somatic mutations, such as ARID1A, PIK3CA, and PTEN, may promote the progression of benign endometriosis to carcinoma. Endometriosis has been implicated in the development of other malignancies, including endometrial and breast cancer. In this review, we critically appraise the data regarding the association between endometriosis and ovarian cancer and the potential correlation of endometriosis with other cancers.
Children of incarcerated fathers reported more depressive symptoms and their teachers noted more externalizing behaviors, after controlling for other biopsychosocial risks. Interventions targeted to ameliorate the distress of children with incarcerated fathers should be considered.
Objective
To examine facilitators and barriers to HPV vaccine uptake in African-American, Haitian, Latina, and White women ages 18–22 and to determine vaccination completion rates among participants over 5 years.
Design
Using semi-structured interviews and medical record review, we assessed HPV knowledge and attitudes towards HPV vaccination among young women. We then determined their subsequent HPV vaccination initiation and completion rates. We used constructs from the Health Belief Model and methods based in grounded theory and content analysis to identify attitudes towards HPV vaccination cues to initiate vaccination, perception of HPV, and how communication about issues of sexuality may impact vaccine uptake.
Participants
We enrolled 132 African-American, Haitian, Latina, and White women aged 18–22 years who visited an urban academic medical center and two affiliated community health centers between the years 2007 and 2012.
Main Outcome Measures
Intent to vaccinate and actual vaccination rates
Results
Of 132 participants, 116 (90%) stated that they were somewhat or very likely to accept HPV vaccination if offered by their physician, but only 51% initiated the vaccination over the next 5 years. Seventy-eight percent of those who initiated vaccination completed the 3 doses of the HPV vaccine series. Forty-five percent (45%, n=50) of the adolescents who started the series completed three doses over a five year period: forty-two percent African-American (n=16), thirty-three percent Haitian (n=13), sixty-three percent Latina (n=10), and sixty-five White young women (n=11) completed the three-dose series. Despite low knowledge, they reported high levels of trust in physicians and were willing to vaccinate if recommended by their physicians.
Conclusion
Desire for HPV vaccination is high among older adolescents, physician recommendation and use of every clinic visit opportunity may improve vaccine uptake in young women. More White young women completed the HPV vaccine series compared with other race and ethnic young women.
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