Interventions to close the divide for women with breast and cervical cancer between low-income and middle-income countries and high-income countries

Denny, Lynette; Sanjosé, Sílvia de; Mutebi, Miriam; Anderson, Benjamin O.; Kim, Jane; Jerónimo, José; Herrero, Rolando; Yeates, Karen; Ginsburg, Ophira; Sankaranarayanan, Rengaswamy

doi:10.1016/s0140-6736(16)31795-0

Cited by 179 publications

(189 citation statements)

References 72 publications

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“…HPV testing is more reliable and less dependent on human expertise than visual inspection with acetic acid (VIA) or cytology (Pap tests) (2). Even more important, HPV testing is more sensitive than VIA or cytology for the detection of cervical cancer/ precancer, and a negative result provides longer reassurance to the woman that she in not at substantial risk of developing cervical cancer (3,4).…”

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confidence: 99%

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Assessment of a New Lower-Cost Real-Time PCR Assay for Detection of High-Risk Human Papillomavirus: Useful for Cervical Screening in Limited-Resource Settings?

et al. 2017

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Inexpensive and easy-to-perform human papillomavirus (HPV) tests are needed for primary cervical cancer screening in lower-resource regions. In a convenience sample of 516 residual exfoliative cervical specimens from the Kaiser Permanente Northern California and U.S. National Cancer Institute Persistence and Progression Study, we assessed the agreement and clinical performance of a simple, inexpensive real-time PCR assay for the detection of 13 carcinogenic HPV types (the H13 assay; Hybribio, Hong Kong) that is marketed in limited-resource settings compared to previous testing by the Hybrid Capture 2 assay (HC2; Qiagen, Germantown, MD) and the Onclarity assay (BD Diagnostics, Sparks, MD). The test set was chosen to include many HPV-positive specimens. The reference standard was a combination of HC2 and Onclarity results for HPV detection and histologic diagnosis of controls (less than cervical intraepithelial neoplasia grade 2 [ϽCIN2]) or cases (cervical intraepithelial neoplasia grade 2 or higher [CIN2ϩ]) for disease status. In this enriched convenience sample, H13 tested positive for 94.4% of the 108 HC2-and Onclaritypositive CIN2ϩ specimens and negative for 88.2% of the 51 HC2-and Onclaritynegative ϽCIN2 specimens. H13 positivity was significantly lower than that of HC2 among women with CIN2ϩ (89.9% versus 98.7%, respectively) (P Ͻ 0.001) and ϽCIN2 (53.5% versus 72.4%, respectively) (P Ͻ 0.001). In conclusion, H13 corresponds well to the combination of HC2 and Onclarity and has good clinical accuracy compared to histologic diagnosis, with less cross-reactivity with untargeted HPV types than HC2. H13 is a lower-cost HPV DNA test that might be useful for primary screening in limited-resource settings.KEYWORDS human papillomavirus, HPV, HPV testing, PCR-based assay, accuracy, cervical cancer, high-risk HPV, limited resource settings, prevention, screening, validation W ith the recognition that persistent infection with human papillomavirus (HPV) is the main factor leading to the development of cervical cancer, technological advances in the last 2 decades have made vaccination the major primary prevention strategy. Moreover, testing for high-risk HPV DNA is a complementary strategy for

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confidence: 99%

“…Cost and ease of use ultimately determine the feasibility of incorporating a screening test into cervical cancer prevention strategies in lowresource areas (2), but accuracy comparable to that of well-validated tests must be maintained.…”

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Assessment of a New Lower-Cost Real-Time PCR Assay for Detection of High-Risk Human Papillomavirus: Useful for Cervical Screening in Limited-Resource Settings?

et al. 2017

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“…Já as medidas específicas para o controle do este tumor focam-se no emprego de ações de detecção precoce e na oferta de tratamento oportuno 1,[4][5][6] .…”

Section: Ações Do Enfermeiro Na Detecção Precoce Do Câncer Mamáriounclassified

Ações do enfermeiro na detecção precoce do câncer mamário [Nurses’ role in early detection of breast cancer] [Acciones del enfermero en la detección temprana del cáncer de mama]

2017

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RESUMOObjetivo: analisar as ações dos enfermeiros de unidades básicas de saúde (UBS) para a detecção precoce do câncer de mama, bem como a estrutura desses serviços. Método: estudo transversal em 2011, aprovado por Comitê de Ética (nº 0185.0162.162-09). Aplicados questionários validados a 13 enfermeiros, quatro gestores e 85 usuárias de quatro UBS paulistanas. Analisaram-se descritivamente os recursos e capacitações ofertados, a frequência com que ocorreram o exame clínico das mamas (ECM) e as reuniões educativas sobre o tema. Resultados: 61,5% dos enfermeiros possuíam protocolo; 23% foram capacitados; 46,2% faziam reuniões educativas; 92,3% realizavam ECM com indicação anual (66,7%) sem idade-alvo (58,5%). Existiam 22 consultórios para 25 médicos e outros sete consultórios para 15 enfermeiros. Enfermeiros capacitados alcançaram maior conformidade prática à recomendação ministerial que os demais. Conclusão: os enfermeiros realizam ações de detecção do câncer de mama, mas constam algumas inconformidades em relação ao preconizado pelo governo, sendo a capacitação e a estrutura da UBS preditoras de maior alcance ao recomendado. Palavras-chave: Enfermagem; neoplasias da mama; atenção primária à saúde; programas de rastreamento. ABSTRACTObjective: to examine the actions of nurses towards early detection of breast cancer in primary health care (PHC) services, as well as the structure of such services. Method: in this cross-sectional study (with ethics committee approval No. 0185.0162.162-09), validated questionnaires were applied to 13 nurses, 4 managers and 85 users from 4 PHC facilities in São Paulo State in 2011. The resources and training offered and the frequency of clinical breast examinations (CBE) and breast cancer education meetings were analyzed descriptively. Results: 61.5% nurses had screening guidelines; 23% had been trained; 46.2% held educational meetings; 92.3% performed CBE, 66.7% with annual indication and 58.5% with no target age. There were 22 offices for 25 physicians and another 7 offices for 15 nurses. There were 22 consulting rooms for 25 physicians and only 7 for 15 nurses. Trained nurses attained better compliance with ministry of health recommendations that other nurses. Conclusion: nurses perform breast cancer detection actions, but there is some noncompliance with governmental guidelines, while training and PHC facility structure were predictors of better compliance with recommendations. Keywords: Nursing; breast neoplasm; primary health care; mass screening. RESUMEN Objetivo: analizar las acciones de los enfermeros de atención primaria de salud (APS) para la detección temprana del cáncer de mama, así como la estructura de estos servicios. Método: estudio transversal en 2011, aprobado por el Comité de Ética (nº 0185.0162.162-09). Se aplicaron cuestionarios validados a 13 enfermeros, 4 gestores y 85 usuarias de 4 servicios de APS de la ciudad de São Paulo. Se analizaron descriptivamente los recursos y capacitaciones ofertadas, la frecuencia del examen clínico de las mamas (ECM) y reuniones ...

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“…In the 1 November issue of The Lancet in 2016, three papers and three accompanying editorials reviewed the descriptive epidemiology of breast and cervical cancer in low-income countries, highlighting the shortcomings of current efforts at cancer control and the need for improvement [1][2][3][4][5][6] . The authors of the three papers overlap and appear to have reached a consensus on the ideology of change.…”

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confidence: 99%

“…Cervical cancer can be prevented through vaccination against the human papillomavirus, and priority should be given to ensuring that vaccines are made available to as many young women as possible 2 . Cervical cancer screening is among the few cancer screening efforts that are an unequivocal success, and the authors cite studies of acetic acid staining as a tool for the detection of early cervical lesions 2 .…”

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confidence: 99%

Women with Cancer in Low-Income Countries

Narod

2017

Current Oncology

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Interventions to close the divide for women with breast and cervical cancer between low-income and middle-income countries and high-income countries

Cited by 179 publications

References 72 publications

Assessment of a New Lower-Cost Real-Time PCR Assay for Detection of High-Risk Human Papillomavirus: Useful for Cervical Screening in Limited-Resource Settings?

Assessment of a New Lower-Cost Real-Time PCR Assay for Detection of High-Risk Human Papillomavirus: Useful for Cervical Screening in Limited-Resource Settings?

Ações do enfermeiro na detecção precoce do câncer mamário [Nurses’ role in early detection of breast cancer] [Acciones del enfermero en la detección temprana del cáncer de mama]

Women with Cancer in Low-Income Countries

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