Changing character of cervical cancer in young women.

Elliott, Peter; Tattersall, Martin H. N.; Coppleson, Malcolm; Russell, Peter; Wong, Frances; Coates, Alan S.; Solomon, Hannah; Bannatyne, Patricia; Atkinson, K.; Murray, John

doi:10.1136/bmj.298.6669.288

Cited by 68 publications

(21 citation statements)

References 3 publications

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“…The majority of invasive cancers are squamous cell carcinomas, although greater prevalence of adenocarcinoma and adenosquamous carcinoma in young women have been reported [25][26][27][28]. In the present study, the mean age of the subjects was 39 years (range, 27-62 years), which is younger than the squamous cell carcinoma cases examined in our previous study in Japan [29].…”

Section: Discussionmentioning

confidence: 71%

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Prevalence, viral load, and physical status of HPV 16 and 18 in cervical adenosquamous carcinoma

et al. 2009

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Adenosquamous carcinoma of the uterine cervix is a rare mixture of malignant squamous and glandular epithelial elements and accounts for approximately 10% of cervical carcinomas. The aims of the present study were to evaluate the prevalence, physical status, and viral load of HPV 16 and 18 in adenosquamous carcinoma. Formalin-fixed paraffin-embedded tissue samples from 20 cases of histologically diagnosed adenosquamous carcinoma were examined. The squamous and glandular components were separately microdissected and analyzed for their HPV DNA subtype, viral load, and physical status using real-time polymerase chain reaction (PCR). The percentages of HPV 16- and 18-positive cases among all the HPV-positive cases were 36.8% (7/19) and 57.9% (11/19) in the squamous epithelial elements and 33.3% (6/18) and 61.1% (11/18) in the glandular elements, respectively. PCR analysis with E2 primers revealed that seven of eleven (63.6%) HPV 18-positive cases had the pure integrated form in both elements. The mean HPV 16 DNA copy numbers/cell was 7.22 in the squamous elements and 1.33 in the glandular elements (p=0.04) while the corresponding mean HPV 18 DNA copy numbers/cell was 1.50 and 0.89, respectively. The prevalence of HPV 18 in adenosquamous carcinoma was high and many HPV 18-positive cases were the pure integrated form resulting in very low copy numbers/cell. It is possible that more aggressive transformation with early integration of HPV 18 results in cases with greater chromosomal instabilities, higher growth rates, and rapid progression.

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Section: Discussionmentioning

confidence: 71%

“…Many reports have suggested that the incidence of cervical cancer in young women is continuing to increase steadily [23][24][25]. The majority of invasive cancers are squamous cell carcinomas, although greater prevalence of adenocarcinoma and adenosquamous carcinoma in young women have been reported [25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Prevalence, viral load, and physical status of HPV 16 and 18 in cervical adenosquamous carcinoma

et al. 2009

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“…Problems are not confined to pregnancy and include secondary infertility2 and development of cervical abnormalities in younger age groups 3…”

Section: Introductionmentioning

confidence: 99%

School sex education: an experimental programme with educational and medical benefit

Mellanby

Phelps

Crichton

et al. 1995

BMJ

118

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Objectives-To develop and teach a school sex education programme that will lead to a decrease in sexual activity.Design-A matched internal and external control experiment, comparing control populations which received their own sex education programmes with populations which received a novel sex education intervention that included medical and peer led teaching.Setting-Comprehensive secondary schools; control and intervention populations within Devon, and distant controls from rural, semiurban, and urban areas of England excluding major conurbations.Subjects-Schoolchildren were taught from age 12 to 16; three successive cohorts of students were evaluated in school year 11 (mean age 16.0).Main outcome measures-Questionnaire conducted under "examination conditions" and invigilated by the research team and other trained medical staff. Results-In the intervention population, progressive increase in knowledge related to contraception, sexually transmitted diseases, and prevalence of sexual activity (X2 (trend) P<0-001 for all three series); relative increase between intervention and control populations in knowledge, relative decrease in attitudes suggesting that sexual intercourse is of itself beneficial to teenagers and their relationships, relative decrease in sexual activity, and relative increase in approval of their "sex education" (relative risk > 1-00 with 95% confidence limits not including 1 00 for all series and for comparisons with both control populations); odds ratio (control v programme) for sexual activity of 1*45, controlling for sociodemographic variables.Conclusion-School sex education that includes specific targeted methods with the direct use of medical staff and peers can produce behavioural changes that lead to health benefit.

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“…Similar to malignant melanoma, breast and cervical cancer also display biphasic Gompertzian mortality rate dynamics (Riggs 1991a(Riggs , 1992b. The two segments of Gompertzian mortality in these two cancers correlate with their separation into pre-and post-menopausal varieties with their distinctive clinical and biological features (Paffenbarger, Kampert andChang 1980, Elliot, Tattersall, Coppleson, Russell, Wong, Coates, Solomon, Bannatyne, Atkinson andMurray 1989). The higher exponential rates of increasing mortality noted at younger ages in breast and cervical cancer have been associated with a biologically more aggressive neoplasm that is also more dependent upon genetic influences (Paffenberger et al 1980, Elliot et al 1989).…”

Section: Discussionmentioning

confidence: 94%

Biphasic Gompertzian malignant melanoma mortality rate dynamics: a manifestation of population genetic heterogeneity

1995

Annals of Human Biology

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The Gompertz equation describes an exponential relationship between mortality and ageing. However, mortality in animal and human populations does not increase exponentially at older ages. Age-specific malignant melanoma mortality rate distributions in the white population of the United States from 1979 to 1989 displayed two distinct Gompertzian slopes; one between age 15 and 35 years, and a second between age 45 and 85 years. Rather than indicating a "biological' limitation of the Gompertz law, multiphasic and upper age boundaries to Gompertzian mortality rate dynamics are a mathematical requirement in genetically heterogeneous populations.

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Changing character of cervical cancer in young women.

Cited by 68 publications

References 3 publications

Prevalence, viral load, and physical status of HPV 16 and 18 in cervical adenosquamous carcinoma

Prevalence, viral load, and physical status of HPV 16 and 18 in cervical adenosquamous carcinoma

School sex education: an experimental programme with educational and medical benefit

Biphasic Gompertzian malignant melanoma mortality rate dynamics: a manifestation of population genetic heterogeneity

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