Multivariate Analysis on the Effects of Diabetes and related Clinical Parameters on Cervical Cancer Survival Probability

Gillani, Syed Wasif; Zaghloul, Hisham A.; Ansari, Irfan Altaf; Abdul, Mohi Iqbal Mohammad; Sulaiman, Syed Azhar Syed; Baig, Mirza R.; Rathore, Hassaan Anwer

doi:10.1038/s41598-018-37694-1

Cited by 11 publications

(6 citation statements)

References 25 publications

(27 reference statements)

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“…While there is limited evidence that women with diabetes are at higher risk of cervical cancer, there is evidence of worse prognostic indicators and lower survival rates after a cervical cancer diagnosis compared to women without diabetes [1][2][3][4]. For example, in one study with approximately 5-year median follow-up, women with diabetes were approximately 1.5 times more likely to die from early-stage (I-IIA) cervical cancer than women without diabetes [3].…”

Section: Introductionmentioning

confidence: 99%

Cervical cancer screening and predictors of screening by diabetes status

Miller

Pinsky

2022

Cancer Causes Control

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Purpose Women with diabetes have lower survival rates after a cervical cancer diagnosis compared to women without diabetes. Pap smears and human papilloma virus (HPV) testing are highly effective screening tests for cervical cancer, therefore, it is important to know the prevalence of guideline-concordant screening among women with diabetes and understand if their predictors of screening differ. The purpose of this analysis was to assess guideline-concordant cervical cancer screening and predictors by diabetes status. Methods We used the 2019 National Health Interview Survey data, limited to women aged 21–65 years without a previous diagnosis of cancer, a hysterectomy, or diagnosed with diabetes in the year prior to the survey. We considered the Pap and HPV tests together and concordance as being tested within the past 3 years as part of a routine exam. We calculated weighted, adjusted prevalence, and prevalence ratios (PRs) of screening concordance comparing women with diabetes to those without. Results The unadjusted prevalence of concordant screening was 66.5% for women with diabetes compared to 73.3% for women without diabetes (PR = 0.91 95% CI 0.84–0.98). In the fully adjusted model adjusting for factors known to be associated with diabetes and access to healthcare, the association was attenuated and no longer statistically significant (PR = 0.96 95% CI 0.89–1.04). Conclusion Cervical cancer screening concordance was lower in women with diabetes compared to those without overall but the deficit appears to be due primarily to underlying differences in sociodemographic characteristics and access to healthcare and not diabetes independently.

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Section: Introductionmentioning

confidence: 99%

Cervical cancer screening and predictors of screening by diabetes status

Miller

Pinsky

2022

Cancer Causes Control

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“…The scientific literature presents different results for the survival of women with cervical cancer between developed and developing countries. A study conducted in Malaysia between 2010 and 2016 found that the five-year cause-specific survival rate was about 90% 31 . Another study, conducted in Japan between 2000 and 2009, reported an 80% specific survival rate for this disease for a three-year follow-up for women over 75 years of age 32 .…”

Section: Discussionmentioning

confidence: 99%

Cervical cancer specific survival in Grande Cuiabá, Mato Grosso State, Brazil

Lima

Souza

Oliveira

et al. 2022

Rev. bras. epidemiol.

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Objective: To estimate specific five-year survival in women diagnosed with cervical cancer living in the municipalities of Cuiabá and Várzea Grande, in the state of Mato Grosso, Brazil. Methods: This is a retrospective cohort study with information from the Cuiabá Population-based Cancer Registry and the Mortality Information System. To estimate the probability of specific survival in five years, the Kaplan-Meier estimator and the log-rank test were used aiming at verifying if there were statistical differences in the lifetime per groups. To verify the proportionality of the failure rates, the Schoenfeld residual test was used according to the statistical significance level of 0.05. Results: Specific five-year survival and median time were 90.0% and 50.3 months, respectively, for cervical cancer. When analyzing by age, the highest specific survival was among women aged 20 to 49 years (91.7%) and median time was 53.3 months. For the histological type, the highest specific survival was among women with adenocarcinoma (92.3%) and the mean survival time was 53.5 months. Conclusion: This study showed that specific survival after five years of diagnosis remained about 90% in patients with cervical cancer. Patients aged 20 to 49 years had higher specific survival and there was statistically significant difference only between age groups.

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“…Early preclinical data suggested that patients with diabetes have an approximately 1.5-or 2-fold higher risk of some common cancers, such as endometrial (1.61-1.89) and breast (1.56) cancers [44,45]. Chen et al and Gillani et al also found that diabetes causes poorer overall survival, poorer recurrence-free survival, and poorer cancerspecific survival in cervical cancer patients [46,47]. Combination chemotherapy decreases the risk of resistance to enhance effectiveness as compared with single-drug therapy for cancer patients; however, multiple drugs may increase the risk of drug interaction and the number of side effects.…”

Section: Discussionmentioning

confidence: 99%

Metformin Potentiates the Anticancer Effect of Everolimus on Cervical Cancer In Vitro and In Vivo

Chen

Yang

et al. 2021

Cancers

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Cervical cancer is globally the fourth most common cancer in women. Metformin is a widely used drug for the treatment of type II diabetes and has been shown to possess important anticancer properties in cervical cancer. Everolimus is an mTOR inhibitor and is widely used to treat NETs, RCC, TSC, and breast cancers. The present study investigated the anticancer effects of metformin and everolimus in cervical cancer, when used alone or in combination. CaSki and C33A human cervical cancer cells were treated with different concentrations of everolimus alone or in combination with metformin. Cell viability was assessed using a CCK-8 assay. Cell apoptosis, cell-cycle, and mtROS analyses were conducted using flow cytometry. Target protein levels were analyzed by Western blotting. Related mechanisms were confirmed using appropriate inhibitors (z-VAD-fmk and BIRB796). The in vitro results were further confirmed in a xenograft tumor study. Both metformin and everolimus, when used alone, were moderately effective in inhibiting cell proliferation and inducing cell apoptosis of CaSki and C33A cells. When used in combination, these two drugs synergistically inhibited the growth of human cervical cancer cells and xenografts in nude mice, promoted sub-G1- and G0/G1-phase cell-cycle arrest, and enhanced mtROS production. The protein expressions of PI3K (p110α) and p-AKT were significantly downregulated, while P27, P21, p-p38, p-ERK, and p-JNK were upregulated following combined treatment. These results revealed that metformin potentiates the anticancer effect of everolimus on cervical cancer, and combination treatment with metformin and everolimus provides a novel therapeutic strategy for patients with cervical cancer.

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Multivariate Analysis on the Effects of Diabetes and related Clinical Parameters on Cervical Cancer Survival Probability

Cited by 11 publications

References 25 publications

Cervical cancer screening and predictors of screening by diabetes status

Cervical cancer screening and predictors of screening by diabetes status

Cervical cancer specific survival in Grande Cuiabá, Mato Grosso State, Brazil

Metformin Potentiates the Anticancer Effect of Everolimus on Cervical Cancer In Vitro and In Vivo

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