Evidence-based Screening, Early Diagnosis and Treatment Strategy of Cervical Cancer for National Policy in Low-resource countries: Example of India

Saxena, Upma; Sauvaget, Catherine; Sankaranarayanan, Rengaswamy

doi:10.7314/apjcp.2012.13.4.1699

Cited by 44 publications

(28 citation statements)

References 32 publications

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“…Nonetheless, testing for the presence of HPV is suggested to be the most reproducible and sensitive primary screening method for women aged 30 years or older, and this approach can be used as an alternative to cytology as the primary screening test for cervical neoplasia [2,3].…”

Section: Introductionmentioning

confidence: 99%

Risk of invasive cancer among women visually screened and colposcopy triaged by trained nurses in rural south India

Thulaseedharan

Malila

Esmy

et al. 2015

International Journal of Gynecology & Obstetrics

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Section: Introductionmentioning

confidence: 99%

Risk of invasive cancer among women visually screened and colposcopy triaged by trained nurses in rural south India

Thulaseedharan

Malila

Esmy

et al. 2015

International Journal of Gynecology & Obstetrics

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“…Cervical cancer is one of the most common cancers in India [10] . The phenotypic changes of cervical cancer are always preceded by genetic damage caused by various carcinogens.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, this method in conjunction with present cytology-based test will be a helpful tool for triage, follow up or treatment of borderline or doubtful cases. [10] There was a gradual and stepwise increase in MNscore from normal to ASCUS to ASC-H to HSIL and to invasive SCC. Analysis of variance(ANOVA) was applied to analyse the difference in mean values of MN-scores among different groups.…”

Section: Introductionmentioning

confidence: 99%

Role of Micronuclesus in Cervical Intraepithelial Lesions and Carcinoma

Reddy

Verma

Jacob

et al. 2017

APALM

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Background: Micronuclei (MN) are considered sensitive indicators of chromosomal damage. Studies have emphasized the utility of MNscoring in detection of increased risk of various cancers in humans. More recent studies have shown MN assay to be highly promising in cervical cancer screening. Aims:To evaluate the utility of micronuclei in distinguishing various squamous intraepithelial lesions and invasive squamous cell carcinoma of cervix. Methods:In this descriptive study, a total of 100 cases were studied, of which 50 were normal (control), 10 were high grade squamous intra epithelial lesions (HSIL) and 26 were invasive squamous cell carcinomas (SCC). Remaining 14 cases were equivocal entities comprising 3 ASCUS and 11 ASC-H cases. In each case, MN-count was done per 1000 epithelial cells and a consensus MN-score was taken after a consensus and careful review by 4 cytopathologists. Results:The mean MN-score showed a gradual increase from normal smear to invasive SCC cases. MN-score of HSIL and invasive SCC were significantly higher than the normal and ASC-H smears. Cases with premalignant/ malignant outcome had a significantly high MNscore as compared to cases with reactive outcome. Conclusion:MN-scoring is a simple, non invasive and cost effective test, which can be performed on an easily collected exfoliated cell sample. MN-assay in conjunction with conventional Pap test can be an effective tool for screening cervical cancer and identifying women at risk.

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“…In low-income countries, cryotherapy provided by physicians is a safe and effective method for the outpatient treatment of cervical intraepithelial neoplasia (CIN), with cure rates exceeding 86% for CIN confined to the visible part of the cervix (Poomtavorn et al, 2009;Saxena et al, 2012). Cryotherapy was successful in the treatment of subclinical HPV infection and prevented the development of clinical disease (Mohanty and Lowe, 1990;Jacob et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Local Cervical Immunity in Women with Low-grade Squamous Intraepithelial Lesions and Immune Responses After Abrasion

Ekalaksananan

Malat²,

Pientong³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Minor trauma to the uterine cervix is supposed to induce local immunity to prevent cervical lesions caused by human papillomavirus (HPV) infection. This study aimed to investigate the local cervical immunity in women with low grade squamous intraepithelial lesion (LSIL) and effects of abrasion after cryosurgery or Pap smear. One hundred women with LSIL and known results of HPV detection were recruited. HPV positive women were randomly divided according to abrasion into cryotherapy and Pap smear observation groups. Cervical tissues and cervico-vaginal lavage (CVL) were collected at 6 and 12 months after allocation. The levels of cytokines at first recruitment were compared with cytokine levels at 6 months after abrasions. The mRNA of IFN-γ , TNF-α and IL-10 in cervical tissues and these cytokines secreted in CVL were determined using real time PCR and ELISA, respectively. Anti-HPV16 IgG and IgA antibodies in CVL were assessed by western blotting. At first recruitment of women with LSIL (100 cases), IL-10 mRNA and cytokine in HPV positive group (60 cases) was significantly higher than negative group (40 cases). IFN-γ and TNF-α mRNA level in both groups were comparable but their secretions in CVL were significantly increased in HPV negative group. After abrasion for 6 months in HPV-positive women, all mRNA and secreted cytokines were changed, but no significant difference was observed between cryotherapy and observation groups. When individuals were compared between first recruitment and after abrasion for 6 months, IFN-γ mRNA and anti-HPV16 L1 IgA antibodies were significantly increased in the cryotherapy group. The results suggest that modulation of local cervical immunities by abrasion might promote different effects in clearance of HPV-related cytological abnormalities.

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Evidence-based Screening, Early Diagnosis and Treatment Strategy of Cervical Cancer for National Policy in Low-resource countries: Example of India

Cited by 44 publications

References 32 publications

Risk of invasive cancer among women visually screened and colposcopy triaged by trained nurses in rural south India

Risk of invasive cancer among women visually screened and colposcopy triaged by trained nurses in rural south India

Role of Micronuclesus in Cervical Intraepithelial Lesions and Carcinoma

Local Cervical Immunity in Women with Low-grade Squamous Intraepithelial Lesions and Immune Responses After Abrasion

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