Cervical Precancerous Lesions and Cancer among Patients in the Gynaecology Outpatient Department at a Tertiary Hospital in South Africa

Hank, E.; Hoque, Muhammad; Zungu, L.I.

doi:10.7314/apjcp.2013.14.8.4903

Cited by 7 publications

(7 citation statements)

References 16 publications

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“…HIV+ women were more likely to present with CIN or cervical cancer at an earlier age [ 240 ], have higher grade CIN [ 241 , 242 ], faster progression [ 243 ], more likely to experience CIN reoccurrence after treatment [ 236 ], and have poorer treatment and survival outcomes [ 238 , 243 , 244 ]. Antiretroviral therapy was shown to improve treatment outcomes for CIN and cervical cancer [ 245 – 248 ]. While feasibility articles were more comprehensive in nature, we categorized them according to the primary feasibility issue discussed: training needs of health care personnel on cervical cancer management ( n = 6), the lack of medical infrastructure and scarcity of equipment to provide treatment ( n = 5), and more generally, issues of access and awareness ( n = 1) and costs ( n = 2).…”

Section: Resultsmentioning

confidence: 99%

Cervical cancer prevention and treatment research in Africa: a systematic review from a public health perspective

et al. 2016

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BackgroundWomen living in Africa experience the highest burden of cervical cancer. Research and investment to improve vaccination, screening, and treatment efforts are critically needed. We systematically reviewed and characterized recent research within a broader public health framework to organize and assess the range of cervical cancer research in Africa.MethodsWe searched online databases and the Internet for published articles and cervical cancer reports in African countries. Inclusion criteria included publication between 2004 and 2014, cervical cancer-related content pertinent to one of the four public health categories (primary, secondary, tertiary prevention or quality of life), and conducted in or specifically relevant to countries or regions within the African continent. The study design, geographic region/country, focus of research, and key findings were documented for each eligible article and summarized to illustrate the weight and research coverage in each area. Publications with more than one focus (e.g. secondary and tertiary prevention) were categorized by the primary emphasis of the paper. Research specific to HIV-infected women or focused on feasibility issues was delineated within each of the four public health categories.ResultsA total of 380 research articles/reports were included. The majority (54.6 %) of cervical cancer research in Africa focused on secondary prevention (i.e., screening). The number of publication focusing on primary prevention (23.4 %), particularly HPV vaccination, increased significantly in the past decade. Research regarding the treatment of precancerous lesions and invasive cervical cancer is emerging (17.6 %), but infrastructure and feasibility challenges in many countries have impeded efforts to provide and evaluate treatment. Studies assessing aspects of quality of life among women living with cervical cancer are severely limited (4.1 %). Across all categories, 11.3 % of publications focused on cervical cancer among HIV-infected women, while 17.1 % focused on aspects of feasibility for cervical cancer control efforts.ConclusionsCervical cancer research in African countries has increased steadily over the past decade, but more is needed. Tertiary prevention (i.e. treatment of disease with effective medicine) and quality of life of cervical cancer survivors are two severely under-researched areas. Similarly, there are several countries in Africa with little to no research ever conducted on cervical cancer.

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Section: Resultsmentioning

confidence: 99%

Cervical cancer prevention and treatment research in Africa: a systematic review from a public health perspective

et al. 2016

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“…According to the natural history of cervical cancer, women at ages lower than 30 years have more HPV infections than older women, although the virus in this age group tends to regress and it is often self-limited. Moreover, older women may experience the progression of this virus 116 times more frequently than younger women (Malloy et al, 2000;Hank et al, 2013). Therefore, HPV DNA testing after the age of 30 years seems to be more effective than before the age of 30.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Economic Aspects of Cervical Cancer Screening Strategies Worldwide: Discrepancy between Economic Analysis and Policymaking

Nahvijou

Hadji

Ahmad

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Organized cervical screening has decreased the incidence of cervical cancer. However, screening strategies vary in different countries. Objectives: We performed a systematic review to evaluate the economic aspects of different screening methods. Materials and Methods: We searched databases and then data were abstracted from each study. We evaluated articles based on different types of screening tests as well as screening age and intervals, and using incremental cost effectiveness ratio via calculating quality adjusted life years (QALY), or life years gained (LYG) per cost. We compared the incremental cost-effectiveness ratio (ICER) of each study using GDP per capita. Furthermore, we compared national guidelines with recommendations of costeffectiveness studies in different countries. Results: A total of 21 articles met our criteria, of which 19 studies showed that HPV DNA testing, 13 suggested an age of 30 years or more, and 10 papers concluded that at least a 5-year or longer interval were the most cost-effective strategies. In some countries, the national guidelines did not match the recommendations of the cost-effectiveness studies. Conclusions: HPV testing, starting at age 30 years or older and repeated at 5-year or longer intervals, is the most cost-effective strategy in any setting. Closer collaboration with health economists is required during guideline development.

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“…220 These options are generally safe and effective for WLWH. [221][222][223][224][225][226] However, endocervical extension is more frequent among WLWH. 227 Therefore, loop excision is less effective and recurrence rates are higher in WLWH than in HIV-negative patients.…”

Section: Management Of Precancerous Cervical Lesions In Plwhmentioning

confidence: 99%

Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

Reid¹,

Suneja²,

Ambinder³

et al. 2018

J Natl Compr Canc Netw

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People living with HIV (PLWH) are diagnosed with cancer at an increased rate over the general population and generally have a higher mortality due to delayed diagnoses, advanced cancer stage, comorbidities, immunosuppression, and cancer treatment disparities. Lack of guidelines and provider education has led to substandard cancer care being offered to PLWH. To fill that gap, the NCCN Guidelines for Cancer in PLWH were developed; they provide treatment recommendations for PLWH who develop non-small cell lung cancer, anal cancer, Hodgkin lymphoma, and cervical cancer. In addition, the NCCN Guidelines outline advice regarding HIV management during cancer therapy; drug-drug interactions between antiretroviral treatments and cancer therapies; and workup, radiation therapy, surgical management, and supportive care in PLWH who have cancer.

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Cervical Precancerous Lesions and Cancer among Patients in the Gynaecology Outpatient Department at a Tertiary Hospital in South Africa

Cited by 7 publications

References 16 publications

Cervical cancer prevention and treatment research in Africa: a systematic review from a public health perspective

Cervical cancer prevention and treatment research in Africa: a systematic review from a public health perspective

A Systematic Review of Economic Aspects of Cervical Cancer Screening Strategies Worldwide: Discrepancy between Economic Analysis and Policymaking

Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

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