The Natural History of Cervical Cancer in Chinese Women: Results from an 11-Year Follow-Up Study in China Using a Multistate Model

Abstract

Background: It is important to understand the natural history of cervical cancer, which has implications for cancer prevention and management. However, a dearth of studies on the long-term development of cervical cancer exists in China.Methods: We investigated the natural history of cervical cancer in Chinese women by creating a multistate model using 11 years of follow-up data from the Shanxi Province Cervical Cancer Screening Study I conducted from 1999 to 2010. In 1999, a total of 1,997 eligible women, ages 35 to 45 years, were enrolled in Xiangyuan County, Shanxi Province. Participants were followed up in 2005 and 2010, respectively.Results: The average time a subject spent in CIN1 before transiting into another state was 1.4693 years [95% confidence interval (CI): 1.1215-1.9251] and the average time a subject spent in CIN2 was 2.9822 years (95% CI: 1.9790-4.4938). A subject's transition probability from CIN1 to normal increased with time. However, the transition probability from CIN1 to CIN2 was relatively lower, with 3-, 5-, and 10-year transition probabilities of 0.1415, 0.1066, and 0.0437. Comparison of 5-year transition probabilities between CIN2 to normal/CIN1 and CIN2 to CIN3 þ yielded a ratio of 2.74.

Clinical evaluation of human papillomavirus 16/18 oncoprotein test for cervical cancer screening and HPV positive women triage

“…And the positive rate of HPV 16/18 DNA was higher than that of E6 oncoprotein among CIN2/3, however, the disparity of positive rate between these two tests became tiny among cervical cancer patients. A retrospective study conducted in China found that no >20% CIN2 will progress to CIN3+ in 5 years without any intervention or treatment, which is consistent with other studies, and approximately 32% of CIN3 will progress to cancer in 30 years without treatment . In our study, the positive rate of OncoE6 for CIN2 and CIN3 was 13.2% and 44.0%, respectively, so we speculate the E6 positive CIN2 or CIN3 may have a higher risk to progress than negative ones, but no prospective studies have been done to directly prove this so far.…”

Prevalence and genotype distribution of human papillomavirus infection among women: A population‐based study in Dali Bai Autonomous Prefecture, Yunnan Province, China

“…The WHO suggested that a high screening coverage rate of 80% of the population at risk for cervical cancer was an important factor for a successful screening program . Unlike in developed countries, in China, approximately 75 500 patients are newly diagnosed with cervical cancer, with 34 000 deaths occurring every year . Cervical cancer is the fourth most frequent cancer in women and 90% of deaths occur in low‐ and middle‐income countries .…”

Effect of beclin 1 expression on the biological behavior and chemotherapy sensitivity of cervical cancer cells

“…Neoadjuvant chemotherapy is important in cervical cancer treatment, since general chemotherapy drugs may promote tumor cell death by inducing cell apoptosis, but tend to induce drug resistance (2). Autophagy is a process of self-digestion by a cell through the action of enzymes originating within its lysosome of the same cell (3). Autophagy is often induced under conditions of stress that could also lead to cell death (4)(5)(6).…”