Cervical cancer in women under 25 years of age and outside the screening age: Diagnosis profile and long‐term outcomes

Santos, Daniel Zaidan dos; Campos, Cirbia Silva; Vale, Diama Bhadra; Bragança, Joana Fróes; Zeferino, Luíz Carlos

doi:10.1002/ijgo.13553

Cited by 7 publications

(5 citation statements)

References 19 publications

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“…These results were in line that the most histopathological types in cervical cancer patients, namely squamous cell carcinoma (75-90%). 22 The histology results of cervical cancer patients as much as 83% was squamous cell carcinoma, 17% of patients had adenocarcinoma and adenosquamous cell carcinoma. 23 Vitamin A or retinol was a polyisoprenoid compound containing a cyclohexinyl ring.24 Examination of vitamin A status could be done by examining the relative dose response (RDR).…”

Section: Discussionmentioning

confidence: 98%

The Efficacy of Chemotherapy in Advanced-Stage Cervical Cancer on Vitamin A Serum

Rizal

Sanif²,

Novaliani

et al. 2022

Indones J Obstet Gynecol

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Abstract Objective: To determine the efficacy of neoadjuvant chemotherapy on changes of vitamin A serum in advanced cervical carcinoma patient. Method: A randomized clinical trial was performed in the Oncology Gynecology Polyclinic and Ward of Dr. Mohammad Hoesin General Hospital, Palembang from September 2019 to September 2020. There were 30 subjects of advanced cervical carcinoma. Vitamin A levels and tumor volume subjects were assessed before and 1 month after 3 cycles of NAC and analyzed using the Paired T Test and Wilcoxon test. The correlation between vitamin A levels and tumor volume was analyzed by using Spearman's Rho test. Data analysis was using SPSS version 22.0. Results: This study showed statistically not significant increase on vitamin A levels after 3 cycles of NAC chemotherapy (p=0.515). However, there was a significantly decrease in tumor volume after 3 cycles of NAC (p=0.000). In addition, there was a moderate negative correlation between tumor size and vitamin A (r=-0.475; p=0.008). Conclusion: It can be concluded that there was significantly decrease in tumor volume after 3 series NAC chemotherapy and the smaller tumor size, the higher level of vitamin A serum. Keywords: cervical cancer, neoadjuvant chemotherapy, randomized clinical trial, vitamin A, Abstrak Tujuan: Untuk mengetahui efektivitas kemoterapi neoadjuvan terhadap perubahan kadar serum vitamin A pada karsinoma servik stadium lanjut. Metode: Penelitian uji klinik tanpa pembanding telah dilakukan di Poliklinik dan Bangsal Onkologi Ginekologi RSUP Dr. Muhammad Hoesin Palembang sejak September 2019 hingga September 2020. Didapatkan 30 sampel karsinoma serviks stadium lanjut. Kadar vitamin A dan volume tumor dinilai sebelum dan 1 bulan setelah 3 siklus NAC dan dianalsis menggunakan uji Paired T Test dan Wilcoxon. Korelasi antara Kadar vitamin A dan volume tumor sampel dianalisis menggunakan uji Spearman Rho’s. Analisa data menggunakan SPSS versi 22.0. Hasil : Pada penelitian ini terdapat peningkatan tidak signifikan kadar vitamin A setelah kemoterapi (p = 0,515). Terdapat penurunan secara signifikan volume tumor sebelum dan sesudah kemoterapi NAC 3 seri (p = 0,000). Selain itu, didapatkan korelasi negatif sedang yang bermakna antara ukuran tumor dan kadar vitamin A ( r = -0,475 ; p = 0,008). Simpulan : Disimpulkan bahwa terdapat penurunan volume tumor setelah kemoterapi NAC 3 series dan semakin kecil ukuran tumor maka semakin tinggi kadar vitamin A dalam serum. Kata kunci: kanker serviks, kemoterapi neoadjuvan, uji klinik tanpa pembanding, vitamin A.

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Section: Discussionmentioning

confidence: 98%

The Efficacy of Chemotherapy in Advanced-Stage Cervical Cancer on Vitamin A Serum

Rizal

Sanif²,

Novaliani

et al. 2022

Indones J Obstet Gynecol

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“…In the region (Campinas, São Paulo), around half of cervical cancer cases are diagnosed at Stage I. 15 Once most cases are SCC, it may be supposed that HPVA has a more indolent natural history and possible prevention by screening. HPVI, by its more aggressive biologic behavior, 13,14,16,17 is more diagnosed in symptomatic patients, and the effectiveness of screening by cytology or HPV would be limited.…”

Section: Discussionmentioning

confidence: 99%

“…In the HPVA group, 52.0% of the patients were diagnosed at Stage I, and only 17.7% were in the HPVI group ( P = 0.009). In the region (Campinas, São Paulo), around half of cervical cancer cases are diagnosed at Stage I 15 . Once most cases are SCC, it may be supposed that HPVA has a more indolent natural history and possible prevention by screening.…”

Section: Discussionmentioning

confidence: 99%

Prognosis determination of endocervical adenocarcinomas morphologically reclassified as HPV associated or HPV independent

Carvalho

Costa

Sanches

et al. 2022

Intl J Gynecology & Obste

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Objective To evaluate the prognosis of endocervical adenocarcinomas after reclassification according to the morphologic type based on the 2020 World Health Organization Classification. Methods A retrospective longitudinal study with cases admitted at the University of Campinas, Brazil, from 2013 to 2020. The sample included 140 cases morphologically reclassified: 100 cases as adenocarcinoma HPV‐associated (HPVA), 17 as HPV‐independent (HPVI), and 23 non‐HPVA/HPVI. Clinic and pathologic variables were evaluated. Analyses were performed by χ2, Fisher exact, and Mann–Whitney U tests, Kaplan–Meier curves, Log‐rank test, and Cox regression. Results Compared with the HPVA group, advanced stage (FIGO Stage II+) was more frequent in the HPVI group (P = 0.009), which also showed older patients (P = 0.032), and a higher proportion of deaths (P = 0.006). The median overall survival (OS) differed between groups: 73.3 months in HPVA and 42.4 months in HPVI (P = 0.005). At the multivariate analysis, the risk of death was 6.7 (95% confidence interval 1.9–23.0) times higher in patients diagnosed in advanced stages. Conclusion HPVI cases were more frequent in older patients, presenting at more advanced stages and with worse OS. The morphology‐based approach of the new WHO classification appears to be prognostically valuable and applicable in lower‐ and middle‐income settings.

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“…Data were obtained from recent data of long-term prospective studies for cytology and colposcopy/biopsy results after a hrHPV test [ 26 ]. The prevalence of cervical cancer stages in the region was obtained from local data [ 27 ]. The probability of adhering to the screening intervals and health services coverage to search for cases were also considered by the literature [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

Is the HPV-test more cost-effective than cytology in cervical cancer screening? An economic analysis from a middle-income country

et al. 2021

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Objective To report a modelling study using local health care costs and epidemiological inputs from a population-based program to access the cost-effectiveness of adopting hrHPV test. Methods A cost-effectiveness analysis based on a microsimulation dynamic Markov model. Data and costs were based on data from the local setting and literature review. The setting was Indaiatuba, Brazil, that has adopted the hrHPV test in place of cytology since 2017. After calibrating the model, one million women were simulated in hypothetical cohorts. Three strategies were tested: cytology to women aged 25 to 64 every three years; hrHPV test to women 25–64 every five years; cytology to women 25–29 years every three years and hrHPV test to women 30–64 every five years (hybrid strategy). Outcomes were Quality-adjusted life-years (QALY) and Incremental Cost-Effectiveness Ratio (ICER). Results The hrHPV testing and the hybrid strategy were the dominant strategies. Costs were lower and provided a more effective option at a negative incremental ratio of US$ 37.87 for the hybrid strategy, and negative US$ 6.16 for the HPV strategy per QALY gained. Reduction on treatment costs would influence a decrease in ICER, and an increase in the costs of the hrHPV test would increase ICER. Conclusions Using population-based data, the switch from cytology to hrHPV testing in the cervical cancer screening program of Indaiatuba is less costly and cost-effective than the old cytology program.

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Cervical cancer in women under 25 years of age and outside the screening age: Diagnosis profile and long‐term outcomes

Cited by 7 publications

References 19 publications

The Efficacy of Chemotherapy in Advanced-Stage Cervical Cancer on Vitamin A Serum

The Efficacy of Chemotherapy in Advanced-Stage Cervical Cancer on Vitamin A Serum

Prognosis determination of endocervical adenocarcinomas morphologically reclassified as HPV associated or HPV independent

Is the HPV-test more cost-effective than cytology in cervical cancer screening? An economic analysis from a middle-income country

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