This article describes a Protocol for a study to determine a scope of Human Papillomavirus (HPV) infection and evaluate cervical cancer prevention measures in the western Kazakhstan. Introduction-ICO (Institut Catala d'Oncologia) working group in 2015 informed that cervical cancer in Kazakhstan ranked as the 1st most frequent cancer among 15-44 aged women. Aim-comprehensive analysis of the HPV infection across the female population to predict further trends in the cervical cancer morbidity and outline the circle of urgent preventive measures. The most important tasks are the following: to analyze a set of clinical, laboratory and socio-demographic data for identification the region-specific risk factors of the disease; to present a comparative analysis of diagnostic screening tools practiced in the region for the development corrective recommendations for existing screening strategy. Methods-This study constitutes a mix of three different types: interview+cross-sectional study for general female population and interview+case-control study for women with the first time diagnosed cervical cancer, where women of the general sample of the same age with detected HPV infection but not affected by the disease serve as a control for those with the disease. Anticipated Results-A high feasibility and pithiness of this study is expected. Obtaining a wide body of information relatively HPV scope and a quality of the screening process during a patient's single visit is the main strength of the research. Conclusion-Successful implementation of challenges announced in the research can lead to changing a general vector or/and constituent parts of the existing screening program.

Objective To assess the effectiveness of the current cervical cancer screening tools in Western Kazakhstan. Methods Smears taken through (i) conventional cytology using azur-eosin staining and (ii) liquid-based cytology (LBC) ‘Cell Scan’ in the general female population and in women first diagnosed with cervical cancer were collected throughout the region. ROC-analysis with curve construction and weighted Cohen's κ calculation were applied. A total of 494 cytological pairs were collected, including 94 sets with histology findings. Results The conventional (azur-eosin staining) technique contained 0.2% non-informative material and LBC ‘Cell Scan’ had 5.9%. Area under the curve was 0.95 for the conventional technique and 0.92 for ‘Cell Scan’ ( p > 0.05). The conventional smears showed κ 0.62, sensitivity 90.4% at specificity 90.0% for CIN2+, while LBC ‘Cell Scan’ smears showed κ 0.47, sensitivity 83.3% at specificity 92.5%. Conclusions In this analysis it was not possible to prove that the LBC ‘Cell Scan’ technique was superior to its predecessor, azur-eosin staining. These findings highlight the need to modify the current screening programme according to updated international scientific evidence on effective screening design, such as the use of HPV DNA testing with Pap smear triage in women aged 30 or older. Further research, and a Health Technology Assessment, are necessary if we wish to establish a national standardized screening programme using the available technology appropriately.

High-risk human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on how the high extent of carcinogenicity is eventually formed due to the infection by the Papoviridae family would contribute to enhancing current prevention strategies not only towards cervical cancer, but also other HPV associated cancers. This review article is aimed at presenting the key points in two directions: the current cervical cancer prevention and related aspects of HPV behavior. Virtually all applied technologies related to HPV diagnostics and screening programs, such as HPV tests, colposcopy-based tests (VIA/VILI), conventional and liquid-based cytology, currently available are presented. Issues of availability, advantages, and drawbacks of the screening programs, as well as vaccination strategies, are also reviewed in the article based on the analyzed sources. The current point of view regarding HPV is discussed with emphasis on the most problematic aspect of the HPV family concerning the observed increasing number of highly carcinogenic types. Present trends in HPV infection diagnostics throughout the human fluids and tissues are also reported, including the latest novelties in this field, such as HPV assay/self-sample device combinations. Besides, a brief outline of the related prevention issues in Kazakhstan, the leading country of Central Asia, is presented. Kazakhstan, as one of the post-soviet middle-income countries, may serve as an example of the current situation in those terrains, concerning the implementation of globally accepted cervical cancer prevention strategies. Along with positive achievements, such as the development of a nationwide screening program, a range of drawbacks is also analyzed and discussed.

Objective: to detect the HPV types distribution both in general female population and in women with first diagnosed cervical cancer, including viral load in both groups. Methods: Qualitative detection and quantification of HPV was performed by PCR-Real time method based on the Russian equipment and test systems ("DNA-Technology" LLC, Russia). The DNA of low-risk (HPV 6, 11, 44) and possibly / potentially / high carcinogenic risk (HPV 16, 18, 26, 31, 33 , 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 82), a total of 21 types, were detected. Results: During the period of 2014-2017 total 1,166 clinically healthy women were tested for HPV, as well as 73 women diagnosed with CaCx. Overall prevalence of HPV in female population was determined as 25.0% (95% CI 22.3;27.7, p = 0.05). Top-5 leading HPV types: 16 (26.4%); 31 (10.1%); 51 (9.4%); 52 (9.0%); 6 (7.9%). Average viral load was 5.5±3.8 (CI 95% 5.1;5.9). In women diagnosed with CaCx ranking was as follows -16 (54.1%), 31 (11.2%), 18 / 58 (5.1% each), 33 / 45 (4.1% each). Type 16 appeared to be one of the most significant risk factors of the CaCx development (p=0.00007, phi 0.35, Pierson's X 2 15.9). Average viral load in patients with CaCx was 6.9±4.0 (95% CI 6.1;7.7). A reliable relationship between the cancer staging and the viral load was found (p = 0.043, n = 73). Domination of type 16 calls for urgent need the transition to HPV primary screening and resumption of immunization program discontinued in 2014. The study is registered in ISRCTN registry, No. ISRCTN71514910 (01.02.2018).

Most of the country’s oil and gas fields are situated in West Kazakhstan, mainly on the Caspian Sea coast, causing significant damage to the local environment and contributing to an imbalance in the trace element composition of the human body. The study is aimed to evaluate the relationship between the concentration of essential trace elements in scalp hair of the western Kazakhstan adult population and the remoteness of their residence from oil and gas fields. The concentration of essential trace elements (Co, Cu, Fe, I, Mn, Se, Zn) in the hair of 850 individuals aged 18–60 years was determined by inductively coupled plasma mass spectrometry. In residents of settlements located at a distance of >110 km from oil and gas fields, the concentration of Cu and I in hair was significantly higher than in those closer to 110 km (p < 0.001). The content of Cu and I were associated with the distance to oil and gas fields (0.072 (95%CI: 0.050; 0.094)) and (0.121 (95%CI: 0.058; 0.185)), respectively. We detected a significant imbalance in the distribution of some essential trace elements in residents’ scalp hair from the Caspian region of western Kazakhstan, living near oil and gas fields. The concentrations of Cu and I were significantly interrelated with the distance to oil and gas fields. The level of copper in the hair of both inhabitants of the area most remote from oil and gas facilities and the entire population of western Kazakhstan as a whole remains significantly low. The data obtained provide evidence of the possible impact of pollutants generated by the oil and gas facilities on a shortage of essential trace elements and associated subsequent health risks.