ClickMedix founder partnered with University of Pennsylvania and Botswana-UPenn Partnership program to pioneer cervical cancer screening using mobile camera phones.
*Note: This presentation contains medical images which may be unsuitable for those not accustomed.
HPV Diseases More Than Cervical Cancer, Dr. Sharda Jain Lifecare Centre
HPV Disease . Cervical cancer , prevention cervical cancer , HPV prevention , cancer prevention , Human Papillomavirus (HPV), cervical cancer prevention
This document provides an overview of cervical cancer and HPV. It discusses that HPV is the underlying cause of cervical cancer and describes the natural history of HPV infection. HPV is very common and usually clears without symptoms, but sometimes causes pre-cancerous cervical changes that can develop into invasive cancer if left untreated. Screening guidelines and new HPV vaccines are aimed at preventing cervical cancer by detecting and treating pre-cancerous cells or protecting against HPV infection. Regular Pap screening allows most pre-cancer to be detected and treated before it develops into invasive cancer.
Mission SAY No to Cervical Cancer With HPV Vaccination DR. SHARDA JAIN S...Lifecare Centre
1. Cervical cancer is a major health issue in India, accounting for 23% of new cervical cancer cases and 25% of cervical cancer deaths worldwide.
2. Human papillomavirus (HPV) infection causes cervical cancer, with vaccination providing 98-100% efficacy against HPV types.
3. Screening and vaccination can help prevent cervical cancer, but coverage in India remains low due to cost and lack of national programs.
The document provides biographical information about Dr. Narendra Malhotra, an obstetrician gynecologist from Agra, India. It notes that he has served as the president of FOGSI, dean of ICMU, and director of Ian Donald School of Ultrasound. It also lists his accomplishments, publications, areas of special interest, and contact information for his practice.
Cancer Biomarkers Research, HPV and Cancer, HPV VaccineJames Lyons-Weiler
The document discusses HPV (human papillomavirus) and cancer biomarkers. It notes that HPV vaccines target certain high-risk HPV types linked to cancers like cervical cancer. Some studies have found evidence of "type replacement" where non-vaccine HPV types increase in prevalence after vaccination, potentially limiting vaccine effectiveness. However, other studies have not found clear evidence of type replacement or have dismissed observed increases in non-vaccine types. There is ongoing debate about the ability of HPV vaccines to prevent cancer and their long-term safety profile based on limitations in clinical trials.
HPV Infection , HPV Vaccination , Cervical cancer , Cancer in India , Dr. SHA...Lifecare Centre
HPV inefection , HPV disease prevention, Cervical cancer prevention , Cervical cancer treatment, Female cancer , Female cancer prevention , Uterine cancer , Cancer in india
HPV Diseases More Than Cervical Cancer, Dr. Sharda Jain Lifecare Centre
HPV Disease . Cervical cancer , prevention cervical cancer , HPV prevention , cancer prevention , Human Papillomavirus (HPV), cervical cancer prevention
This document provides an overview of cervical cancer and HPV. It discusses that HPV is the underlying cause of cervical cancer and describes the natural history of HPV infection. HPV is very common and usually clears without symptoms, but sometimes causes pre-cancerous cervical changes that can develop into invasive cancer if left untreated. Screening guidelines and new HPV vaccines are aimed at preventing cervical cancer by detecting and treating pre-cancerous cells or protecting against HPV infection. Regular Pap screening allows most pre-cancer to be detected and treated before it develops into invasive cancer.
Mission SAY No to Cervical Cancer With HPV Vaccination DR. SHARDA JAIN S...Lifecare Centre
1. Cervical cancer is a major health issue in India, accounting for 23% of new cervical cancer cases and 25% of cervical cancer deaths worldwide.
2. Human papillomavirus (HPV) infection causes cervical cancer, with vaccination providing 98-100% efficacy against HPV types.
3. Screening and vaccination can help prevent cervical cancer, but coverage in India remains low due to cost and lack of national programs.
The document provides biographical information about Dr. Narendra Malhotra, an obstetrician gynecologist from Agra, India. It notes that he has served as the president of FOGSI, dean of ICMU, and director of Ian Donald School of Ultrasound. It also lists his accomplishments, publications, areas of special interest, and contact information for his practice.
Cancer Biomarkers Research, HPV and Cancer, HPV VaccineJames Lyons-Weiler
The document discusses HPV (human papillomavirus) and cancer biomarkers. It notes that HPV vaccines target certain high-risk HPV types linked to cancers like cervical cancer. Some studies have found evidence of "type replacement" where non-vaccine HPV types increase in prevalence after vaccination, potentially limiting vaccine effectiveness. However, other studies have not found clear evidence of type replacement or have dismissed observed increases in non-vaccine types. There is ongoing debate about the ability of HPV vaccines to prevent cancer and their long-term safety profile based on limitations in clinical trials.
HPV Infection , HPV Vaccination , Cervical cancer , Cancer in India , Dr. SHA...Lifecare Centre
HPV inefection , HPV disease prevention, Cervical cancer prevention , Cervical cancer treatment, Female cancer , Female cancer prevention , Uterine cancer , Cancer in india
Cervical Cancer Vaccine - Do we need it in IndiaGaurav Gupta
The document discusses cervical cancer and the HPV virus. It provides epidemiological data on cervical cancer in India, describing it as the most common cancer in Indian women. It explains the link between HPV infection and cervical cancer, noting that HPV vaccination can prevent most cervical cancers. The document discusses two approved HPV vaccines, Gardasil and Cervarix, comparing their efficacy, safety and immune responses elicited. It recommends HPV vaccination as an important strategy for cervical cancer prevention.
AN OPPORTUNITY FOR HPV VACCINATION , Dr. Sharda Jain Lifecare Centre Lifecare Centre
This document discusses strategies for cervical cancer prevention in India through HPV vaccination. It notes that cervical cancer is almost entirely preventable but prevention efforts in India have been inadequate. HPV vaccination provides strong protection, especially if received before sexual debut. However, vaccination rates in India are very low. The document argues that the postpartum period provides an opportunity for catch-up HPV vaccination that can improve coverage. Several studies show high HPV prevalence in postpartum women, demonstrating the potential benefit. Other evidence suggests postpartum women are receptive to vaccination and compliance with the 3 dose schedule can be high with proper counseling. The document advocates that healthcare providers should recommend HPV vaccination to women in the postpartum period to help control cervical cancer in India
The document discusses HPV vaccination, including:
1) Cervical cancer is a major disease burden in India, with India accounting for about 25% of cervical cancer deaths worldwide. HPV is the cause of nearly all cervical cancers.
2) HPV vaccination aims to prevent cervical cancer by vaccinating against HPV types 16 and 18, which cause about 70% of cervical cancers. Vaccination is recommended for girls and women between ages 9-45 before sexual debut or exposure to HPV.
3) Real-world effectiveness data from Australia's HPV vaccination program shows decreases in HPV vaccine-type infections and high-grade cervical abnormalities in young women following the program.
The document discusses human papillomavirus (HPV) and related diseases like cervical cancer. It notes that HPV types 16 and 18 cause over 70% of cervical cancers worldwide. Cervical cancer rates have declined in countries with organized cervical screening programs. HPV is transmitted sexually and often clears without symptoms, but can sometimes cause cervical lesions and genital warts.
Cervical cancer is a major health problem, but HPV vaccination and screening can reduce rates. HPV is transmitted sexually and can cause cervical cancer. The vaccine protects against high-risk HPV types 16 and 18, which cause most cancers. Northern Ireland has high HPV vaccination rates. While the vaccine reduces cancer risk, screening is still needed since the vaccine does not protect against all HPV types and cannot help women already infected. In the future, screening may shift to HPV testing as prevalence decreases due to vaccination.
Latest update on cervical cancer & hpv vaccine 2013Lifecare Centre
Cervical cancer is a major cause of cancer deaths among women globally, with over 270,000 deaths per year. India has a high burden with over 100,000 new cases annually. Human papillomavirus (HPV) infection is the primary cause, with HPV types 16 and 18 causing over 70% of cervical cancers. Two HPV vaccines, a bivalent and quadrivalent vaccine, provide protection against HPV 16 and 18 and have demonstrated efficacy of over 90% in clinical trials. Ongoing monitoring in Nordic countries has found the quadrivalent vaccine continues to provide protection against HPV 16/18 infection for up to 9 years. Guidelines recommend routine HPV vaccination for girls and boys at age 11-12 to be
Cervical cancer is the second most common cancer in women worldwide. The document discusses opportunities and challenges for cervical cancer prevention including new HPV vaccines and screening assays. It provides an overview of HPV vaccines, countries that have introduced them, and challenges to introduction. Monitoring vaccine coverage and impact is also discussed.
In South Africa women under 30years of age are not offered free cervical smear screening. Howeve it has been noted that a significant percentage of women under 30years are found to have High Grade Lesions in the community which we serve.
The document discusses HPV vaccine recommendations and current issues. It provides an overview of HPV vaccine licensure and recommendations, safety data showing the vaccines are very safe, and low national and state HPV vaccination rates, especially for certain populations. Rates in Indiana are among the lowest in the US. It recommends new strategies are needed to increase HPV vaccine acceptance and reduce disparities.
HPV Vaccination & Ca. Cervix Screening Update Dr. Sharda Jain Dr. Jyoti A...Lifecare Centre
The document discusses the disease burden of cervical cancer in India, providing statistics showing that India accounts for approximately 25-27% of new cervical cancer cases and deaths worldwide despite having a smaller population than other parts of the world. It then discusses the role of HPV in causing cervical cancer, noting that HPV types 16 and 18 cause over 70% of cases. The document recommends HPV vaccination between ages 9-13 when immune response is strongest, and suggests it can provide benefits even for some sexually active women who have not been exposed to all HPV types covered by the vaccine. Long-term follow-up studies show the vaccine continues to provide nearly 100% effectiveness against HPV 16/18-related cervical diseases for many years.
HPV Vaccination Update in 2021 Dr Sharda Jain Lifecare Centre
This document discusses the importance of prioritizing HPV vaccination in India. It notes that cervical cancer is a major problem in India, with over 60,000 deaths per year. However, HPV vaccination rates in India are less than 1%. The document advocates scaling up HPV vaccination programs for adolescent girls according to WHO guidelines. Vaccinating girls before age 15 is key to eliminating cervical cancer as a public health problem. It also discusses opportunities for catch-up vaccination by OBGYNs and nurses when women visit for other women's health issues. The overall message is that HPV vaccination should be a top priority for the Indian government to substantially reduce the cervical cancer burden.
Global lung cancer vaccine market & pipeline insight 2015KuicK Research
“Global Lung Cancer Vaccine Market & Pipeline Insight 2015” Report Highlights:
Introduction to Lung Cancer Vaccine
Global Lung Cancer Vaccine Market Analysis
Global Lung Cancer Vaccine Pipeline by Company & Phase
Global Lung Cancer Vaccine Pipeline: 29 Vaccines
Majority Lung Cancer Vaccines in Phase-II: 8 Vaccines
Marketed Lung Cancer Vaccines: 3 ( BV NSCLC 001, Mycidac-C™ & Vaxira®)
Personalized Cancer Vaccines: Progress & Possibilities
Lung Cancer Vaccine Mechanism
Gardasil - Do we need Cervical Cancer Vaccine in India?Gaurav Gupta
The document provides an overview of HPV disease and the case for HPV vaccination. It discusses the high global and Indian disease burden of cervical cancer caused by HPV, with India accounting for over 27% of new cervical cancer cases and deaths worldwide despite having a small fraction of the global population. Clinical trial data demonstrates over 90% efficacy of the quadrivalent HPV vaccine in preventing cervical, vulvar, vaginal, and anal cancers and genital warts caused by HPV types 6, 11, 16, and 18. Long-term follow up studies show sustained immune memory response and protection for over 7 years. Worldwide and Indian guidelines recommend HPV vaccination for girls aged 9-14 years.
HPV Vaccination, Cerviocal Cancer : Do we need it
for Prevention of cervical cancer &
other HPV related diseasesm,
Presentation Outlines
Cervical cancer disease burden
Prevention with HPV vaccination
Vaccination of sexually active women
Opportunity of Postpartum HPV vaccination
Importance of genital warts prevention
Real world effectiveness data
Safety of HPV vaccine
UPDATE HPV Vaccination IN Cervical Cancer Prevention Dr Sharda Jain Lifecare Centre
Cervical Cancer In India: A Preventable Tragedy That Requires Urgent Attention
It is estimated that in India, about 160 million women aged 30-59 years are at risk of developing cervical cancer, with fatality rate of 50 per cent
This document discusses cervical cancer worldwide and in Saudi Arabia. It provides statistics on the prevalence, incidence, and mortality of cervical cancer globally and within regions. It notes that cervical cancer incidence is very low in Saudi Arabia at 1.9 per 100,000 women but is expected to increase to 309 new cases by 2025. Risk factors, screening and prevention, stages and treatments are summarized.
The document summarizes information about the human papillomavirus (HPV). It notes that HPV is the most common sexually transmitted infection in the US, with over 6 million new cases annually. HPV can cause genital warts and cancers, especially cervical cancer. It discusses HPV types, risk factors, progression of cervical disease, and the HPV vaccine Gardasil. Gardasil was found to be highly effective against HPV types 16 and 18 in clinical trials, providing nearly 100% efficacy against precancerous cervical lesions caused by these high-risk HPV types.
CERVICAL CARCINOMA The Role of the Human Papilloma Virus and Prospects for Pr...Alberto Cuadrado
This document discusses cervical carcinoma and prospects for primary prevention. It summarizes that cervical cancer is the second most common cancer in women worldwide, caused over 99% of the time by human papillomavirus (HPV) infection. Screening methods like Pap smears have been effective in developed countries but are too expensive for low-resource areas. The document explores more affordable options like visual inspection with acetic acid (VIA) and prospects for an HPV vaccination to help developing countries prevent cervical cancer.
This document discusses HPV vaccines and cervical cancer prevention. It provides details on HPV types, transmission, and associated cancers. It outlines recommendations for HPV vaccination including target groups, dosing schedules, and delivery strategies. The goals of HPV vaccination are to reduce the global burden of HPV-related cancers through immunization programs.
O documento discute o vírus do papiloma humano (HPV), que é transmitido sexualmente e pode causar câncer de colo do útero. Ele explica o que é HPV, como se espalha, os tipos de risco alto e baixo, sintomas, exames de detecção e a importância da vacinação e rastreamento para prevenir câncer.
Cervical Cancer Vaccine - Do we need it in IndiaGaurav Gupta
The document discusses cervical cancer and the HPV virus. It provides epidemiological data on cervical cancer in India, describing it as the most common cancer in Indian women. It explains the link between HPV infection and cervical cancer, noting that HPV vaccination can prevent most cervical cancers. The document discusses two approved HPV vaccines, Gardasil and Cervarix, comparing their efficacy, safety and immune responses elicited. It recommends HPV vaccination as an important strategy for cervical cancer prevention.
AN OPPORTUNITY FOR HPV VACCINATION , Dr. Sharda Jain Lifecare Centre Lifecare Centre
This document discusses strategies for cervical cancer prevention in India through HPV vaccination. It notes that cervical cancer is almost entirely preventable but prevention efforts in India have been inadequate. HPV vaccination provides strong protection, especially if received before sexual debut. However, vaccination rates in India are very low. The document argues that the postpartum period provides an opportunity for catch-up HPV vaccination that can improve coverage. Several studies show high HPV prevalence in postpartum women, demonstrating the potential benefit. Other evidence suggests postpartum women are receptive to vaccination and compliance with the 3 dose schedule can be high with proper counseling. The document advocates that healthcare providers should recommend HPV vaccination to women in the postpartum period to help control cervical cancer in India
The document discusses HPV vaccination, including:
1) Cervical cancer is a major disease burden in India, with India accounting for about 25% of cervical cancer deaths worldwide. HPV is the cause of nearly all cervical cancers.
2) HPV vaccination aims to prevent cervical cancer by vaccinating against HPV types 16 and 18, which cause about 70% of cervical cancers. Vaccination is recommended for girls and women between ages 9-45 before sexual debut or exposure to HPV.
3) Real-world effectiveness data from Australia's HPV vaccination program shows decreases in HPV vaccine-type infections and high-grade cervical abnormalities in young women following the program.
The document discusses human papillomavirus (HPV) and related diseases like cervical cancer. It notes that HPV types 16 and 18 cause over 70% of cervical cancers worldwide. Cervical cancer rates have declined in countries with organized cervical screening programs. HPV is transmitted sexually and often clears without symptoms, but can sometimes cause cervical lesions and genital warts.
Cervical cancer is a major health problem, but HPV vaccination and screening can reduce rates. HPV is transmitted sexually and can cause cervical cancer. The vaccine protects against high-risk HPV types 16 and 18, which cause most cancers. Northern Ireland has high HPV vaccination rates. While the vaccine reduces cancer risk, screening is still needed since the vaccine does not protect against all HPV types and cannot help women already infected. In the future, screening may shift to HPV testing as prevalence decreases due to vaccination.
Latest update on cervical cancer & hpv vaccine 2013Lifecare Centre
Cervical cancer is a major cause of cancer deaths among women globally, with over 270,000 deaths per year. India has a high burden with over 100,000 new cases annually. Human papillomavirus (HPV) infection is the primary cause, with HPV types 16 and 18 causing over 70% of cervical cancers. Two HPV vaccines, a bivalent and quadrivalent vaccine, provide protection against HPV 16 and 18 and have demonstrated efficacy of over 90% in clinical trials. Ongoing monitoring in Nordic countries has found the quadrivalent vaccine continues to provide protection against HPV 16/18 infection for up to 9 years. Guidelines recommend routine HPV vaccination for girls and boys at age 11-12 to be
Cervical cancer is the second most common cancer in women worldwide. The document discusses opportunities and challenges for cervical cancer prevention including new HPV vaccines and screening assays. It provides an overview of HPV vaccines, countries that have introduced them, and challenges to introduction. Monitoring vaccine coverage and impact is also discussed.
In South Africa women under 30years of age are not offered free cervical smear screening. Howeve it has been noted that a significant percentage of women under 30years are found to have High Grade Lesions in the community which we serve.
The document discusses HPV vaccine recommendations and current issues. It provides an overview of HPV vaccine licensure and recommendations, safety data showing the vaccines are very safe, and low national and state HPV vaccination rates, especially for certain populations. Rates in Indiana are among the lowest in the US. It recommends new strategies are needed to increase HPV vaccine acceptance and reduce disparities.
HPV Vaccination & Ca. Cervix Screening Update Dr. Sharda Jain Dr. Jyoti A...Lifecare Centre
The document discusses the disease burden of cervical cancer in India, providing statistics showing that India accounts for approximately 25-27% of new cervical cancer cases and deaths worldwide despite having a smaller population than other parts of the world. It then discusses the role of HPV in causing cervical cancer, noting that HPV types 16 and 18 cause over 70% of cases. The document recommends HPV vaccination between ages 9-13 when immune response is strongest, and suggests it can provide benefits even for some sexually active women who have not been exposed to all HPV types covered by the vaccine. Long-term follow-up studies show the vaccine continues to provide nearly 100% effectiveness against HPV 16/18-related cervical diseases for many years.
HPV Vaccination Update in 2021 Dr Sharda Jain Lifecare Centre
This document discusses the importance of prioritizing HPV vaccination in India. It notes that cervical cancer is a major problem in India, with over 60,000 deaths per year. However, HPV vaccination rates in India are less than 1%. The document advocates scaling up HPV vaccination programs for adolescent girls according to WHO guidelines. Vaccinating girls before age 15 is key to eliminating cervical cancer as a public health problem. It also discusses opportunities for catch-up vaccination by OBGYNs and nurses when women visit for other women's health issues. The overall message is that HPV vaccination should be a top priority for the Indian government to substantially reduce the cervical cancer burden.
Global lung cancer vaccine market & pipeline insight 2015KuicK Research
“Global Lung Cancer Vaccine Market & Pipeline Insight 2015” Report Highlights:
Introduction to Lung Cancer Vaccine
Global Lung Cancer Vaccine Market Analysis
Global Lung Cancer Vaccine Pipeline by Company & Phase
Global Lung Cancer Vaccine Pipeline: 29 Vaccines
Majority Lung Cancer Vaccines in Phase-II: 8 Vaccines
Marketed Lung Cancer Vaccines: 3 ( BV NSCLC 001, Mycidac-C™ & Vaxira®)
Personalized Cancer Vaccines: Progress & Possibilities
Lung Cancer Vaccine Mechanism
Gardasil - Do we need Cervical Cancer Vaccine in India?Gaurav Gupta
The document provides an overview of HPV disease and the case for HPV vaccination. It discusses the high global and Indian disease burden of cervical cancer caused by HPV, with India accounting for over 27% of new cervical cancer cases and deaths worldwide despite having a small fraction of the global population. Clinical trial data demonstrates over 90% efficacy of the quadrivalent HPV vaccine in preventing cervical, vulvar, vaginal, and anal cancers and genital warts caused by HPV types 6, 11, 16, and 18. Long-term follow up studies show sustained immune memory response and protection for over 7 years. Worldwide and Indian guidelines recommend HPV vaccination for girls aged 9-14 years.
HPV Vaccination, Cerviocal Cancer : Do we need it
for Prevention of cervical cancer &
other HPV related diseasesm,
Presentation Outlines
Cervical cancer disease burden
Prevention with HPV vaccination
Vaccination of sexually active women
Opportunity of Postpartum HPV vaccination
Importance of genital warts prevention
Real world effectiveness data
Safety of HPV vaccine
UPDATE HPV Vaccination IN Cervical Cancer Prevention Dr Sharda Jain Lifecare Centre
Cervical Cancer In India: A Preventable Tragedy That Requires Urgent Attention
It is estimated that in India, about 160 million women aged 30-59 years are at risk of developing cervical cancer, with fatality rate of 50 per cent
This document discusses cervical cancer worldwide and in Saudi Arabia. It provides statistics on the prevalence, incidence, and mortality of cervical cancer globally and within regions. It notes that cervical cancer incidence is very low in Saudi Arabia at 1.9 per 100,000 women but is expected to increase to 309 new cases by 2025. Risk factors, screening and prevention, stages and treatments are summarized.
The document summarizes information about the human papillomavirus (HPV). It notes that HPV is the most common sexually transmitted infection in the US, with over 6 million new cases annually. HPV can cause genital warts and cancers, especially cervical cancer. It discusses HPV types, risk factors, progression of cervical disease, and the HPV vaccine Gardasil. Gardasil was found to be highly effective against HPV types 16 and 18 in clinical trials, providing nearly 100% efficacy against precancerous cervical lesions caused by these high-risk HPV types.
CERVICAL CARCINOMA The Role of the Human Papilloma Virus and Prospects for Pr...Alberto Cuadrado
This document discusses cervical carcinoma and prospects for primary prevention. It summarizes that cervical cancer is the second most common cancer in women worldwide, caused over 99% of the time by human papillomavirus (HPV) infection. Screening methods like Pap smears have been effective in developed countries but are too expensive for low-resource areas. The document explores more affordable options like visual inspection with acetic acid (VIA) and prospects for an HPV vaccination to help developing countries prevent cervical cancer.
This document discusses HPV vaccines and cervical cancer prevention. It provides details on HPV types, transmission, and associated cancers. It outlines recommendations for HPV vaccination including target groups, dosing schedules, and delivery strategies. The goals of HPV vaccination are to reduce the global burden of HPV-related cancers through immunization programs.
O documento discute o vírus do papiloma humano (HPV), que é transmitido sexualmente e pode causar câncer de colo do útero. Ele explica o que é HPV, como se espalha, os tipos de risco alto e baixo, sintomas, exames de detecção e a importância da vacinação e rastreamento para prevenir câncer.
Cervical cancer is a malignant tumor of the cervix or cervical area. It is caused by the human papillomavirus (HPV). Risk factors include early sexual activity, multiple sexual partners, poor economic status, partners with multiple partners, a weakened immune system, multiple pregnancies, and a history of HPV or other infections. Symptoms can include abnormal bleeding or discharge. Treatment may include total or radical hysterectomy, lymph node removal, or pelvic exenteration. Nurses help relieve patients' anxiety, improve body image, manage pain, and provide education about the condition and treatment.
O documento discute o HPV (Vírus do Papiloma Humano) e fornece informações sobre sua natureza, tipos, sintomas, diagnóstico, tratamento e prevenção, bem como sobre câncer de colo de útero e a vacina contra HPV. Ele também aborda a campanha de vacinação contra HPV no Brasil em nível internacional, nacional, estadual e municipal.
Here are the key details from the case:
- 30-year-old patient presenting for first Pap smear in 3 years
- Asymptomatic
- Pap smear results show ASC-US
The appropriate next step given these details would be:
- Perform colposcopy to evaluate for any visible abnormalities since her Pap was ASC-US. ASC-US indicates some abnormal cells were seen but not enough for a definitive diagnosis of a precancerous lesion. Colposcopy allows for a closer visual examination of the cervix.
- If colposcopy is normal, repeat Pap smear in 6-12 months for follow up since she has not had regular screening.
- If colposcopy shows
Colposcopy involves examining the cervix, vagina, and vulva with a binocular microscope. It allows detection of pre-cancerous and cancerous epithelial changes through identification of vascular patterns and epithelial abnormalities that appear after applying acetic acid or Lugol's iodine. The transformation zone, where squamous and columnar epithelia meet, is the main area of interest as most cervical cancers originate there. A colposcopy examination is considered satisfactory only if the entire transformation zone is visualized.
This document discusses cervical cancer, its causes, symptoms, diagnosis, and treatment. Some key points:
- Cervical cancer is the fourth most common cancer in women worldwide and is caused by human papillomavirus (HPV) infection in over 90% of cases.
- Other risk factors include multiple sexual partners, young age of first intercourse, smoking, and a weakened immune system.
- Symptoms can include abnormal bleeding or discharge. Diagnosis involves exams, Pap tests, HPV tests, biopsies and assessing the cancer stage.
- Cervical cancer is typically treated through surgery, radiation therapy, chemotherapy, or a combination depending on the cancer stage and grade. Vaccines can
O condiloma acuminado é uma DST causada pelo HPV que se caracteriza por verrugas genitais. Transmite-se principalmente por relações sexuais, mas também por roupas íntimas ou toalhas compartilhadas, e pode afetar a pele do pênis, glande, ânus e vagina. O tratamento envolve medicamentos e evitar relações sexuais, e o diagnóstico precoce do HPV é importante para prevenir o câncer do colo do útero.
Viruses are small infectious agents that cannot replicate without a host cell. They contain either DNA or RNA as their genetic material and have a protein capsid that protects the genetic material. Some viruses have an additional envelope outside the capsid. Viruses hijack the machinery of host cells to replicate their genetic material and assemble new virus particles. The replication cycle involves attachment to and entry into the host cell, uncoating of the virus, replication of the genetic material, assembly of new virus particles, and release of progeny viruses. DNA viruses can either integrate into the host cell genome or replicate episomally. RNA viruses use RNA-dependent RNA polymerases or reverse transcriptase. Viruses may cause disease in hosts by
O HPV é um vírus sexualmente transmissível que causa verrugas genitais e pode levar a alguns tipos de câncer. Ele é comum e muitas vezes não causa sintomas, mas pode ser transmitido mesmo sem sintomas. Vacinas estão disponíveis para prevenir alguns tipos de HPV.
El documento proporciona información sobre las lesiones verrucosas inducidas por el virus del papiloma humano (VPH). Explica que existen más de 100 serotipos de VPH, algunos de bajo riesgo y otros de alto riesgo para causar cáncer. Los tipos 16, 18, 31 y 33 tienen un mayor riesgo de transformación maligna y están relacionados con el cáncer de cuello uterino. El VPH se transmite principalmente a través del contacto sexual y puede causar verrugas, displasias y cáncer de cuel
O documento descreve o vírus do papiloma humano (HPV), incluindo que é transmitido sexualmente e infecta áreas genitais, causando verrugas e aumentando o risco de câncer do colo do útero. Também discute a importância da vacinação e do rastreamento para prevenir infecções e lesões precoces.
CERVICAL-CANCER-introduction, screening and preventionssuser002e70
This document provides an introduction to cervical cancer, including:
- Cervical cancer is a major public health problem, with over 660,000 new cases and 350,000 deaths globally each year. India accounts for 20% of new cases.
- HPV infection is the main cause, with types 16 and 18 associated with over 80% of cancers.
- Screening through Pap smear cytology, VIA, or HPV testing and vaccination can help prevent cervical cancer by identifying and treating precancerous lesions.
- Barriers to controlling cervical cancer include lack of screening infrastructure, funding, awareness, and trained healthcare workers.
This document discusses human papillomavirus (HPV) and its role in cervical cancer. It covers topics such as the types of HPV, how persistent high-risk HPV infections can lead to precancerous lesions and cancer, and the mechanisms by which HPV's E6 and E7 proteins cause cancer development by inactivating tumor suppressor proteins. It also addresses HPV prevalence, HPV-associated cancers, cofactors that increase cancer risk, screening and prevention methods like the Pap test and HPV vaccines, as well as treatment options.
Cervical cancer is caused by human papillomavirus (HPV) infection. HPV infection is very common and in most cases does not cause health problems, but some high-risk HPV types can cause cervical cancer over many years if left untreated. Screening through regular Pap tests can detect pre-cancerous changes early so they can be treated before they develop into invasive cancer. A new HPV vaccine protects against the types of HPV that cause most cervical cancers.
Cervical cancer is a major cause of death for women globally. It is caused by certain strains of HPV and develops in the neck of the womb. Women with HIV have a higher risk of cervical cancer. Precancerous lesions can be identified through screening and treated, to prevent the development of cancer. However, screening and treatment options are often limited in resource-poor settings. Palliative care is also important for managing cervical cancer, especially pain control. New vaccines may help prevent HPV infection and future cervical cancer cases.
Don't miss our upcoming webinars! Subscribe today!
In this webinar, Dr. Durand will review the changing landscape of HPV-related diseases and cancers. She will discuss methods of HPV prevention for current cancer patients and cancer survivors. Attendees will learn about the evidence for HPV vaccination in adults. Practical tips will be provided on how to access HPV vaccination.
View the YouTube video: https://youtu.be/wFgpmqOpzC4
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Human papillomavirus (HPV) is a double stranded DNA virus that infects basal epithelial cells. There are over 100 types of HPV, with some causing warts and others being carcinogenic. HPV is transmitted through skin to skin contact and replicates in a differentiation-dependent manner in the epithelium. High risk HPV types like HPV-16 and HPV-18 can lead to cancers like cervical cancer by inactivating tumor suppressor proteins. Diagnosis involves tests like Pap smear, biopsy and PCR. Prevention is through vaccination and safe sex practices, while treatment depends on the condition, ranging from topical creams for warts to surgery for precancerous lesions.
Human papiloma virus and its association to Cervical Cancer
HPV in Saudi Arabia .
Currently I am working in Arar Central Hospital, in Arar city
In Saudi Arabia.
Please do not hesitate to contact us if you require any further information.
Alsultany@hotmail.com
Cervical intraepithelial neoplasia (CIN) are premalignant lesions of the cervix caused by persistent HPV infection. CIN1 lesions often regress on their own while CIN2 and CIN3 lesions have a higher risk of progression to invasive cancer if left untreated. Diagnosis is made through cervical cytology, HPV testing, and colposcopy. Treatment options include ablative procedures like cryotherapy for low-grade lesions and excisional procedures like LEEP for high-grade lesions. Screening programs utilizing Pap smears or visual inspection techniques aim to detect and treat CIN early to prevent the development of invasive cervical cancer.
This document discusses guidelines for human papillomavirus (HPV) and cervical cancer prevention and screening. It covers HPV types and infection, how HPV infection can lead to cancer, and risk factors. It discusses three main approaches to cervical cancer prevention - primary prevention through HPV vaccination, secondary prevention via screening and treatment of precancerous lesions, and tertiary prevention. The document provides details on HPV vaccines, screening recommendations, challenges to vaccination, and treatment options.
1) Squamous cell carcinoma of the head and neck (SCCHN) is the sixth most common cancer worldwide, with 500,000 new cases expected each year. Approximately 2/3 of patients present with locally advanced disease.
2) Risk factors for head and neck cancer include tobacco products, alcohol, chemicals such as asbestos and formaldehyde, and viruses such as HPV. HPV-positive oropharyngeal cancer is an emerging issue.
3) Treatment depends on disease stage, with surgery or radiation used for early stage and multimodality treatment for advanced stages. Outcomes are generally poor with high mortality and recurrence rates. However, HPV-positive cancers have a better prognosis compared to HPV-negative cancers
Dr. nisreen cervical cancer screening in park hayatTariq Mohammed
The document discusses cervical cancer prevalence, incidence, and mortality worldwide and in Saudi Arabia. It notes that cervical cancer is the second leading cause of cancer death in women globally, with over 500,000 new cases and 288,000 deaths annually. In Saudi Arabia specifically, the incidence is very low at 1.9 cases per 100,000 women, accounting for 152 new cases and 55 deaths annually. However, little is known about HPV prevalence and transmission patterns in the country. The challenges in addressing cervical cancer in Saudi Arabia include understanding HPV and abnormal cytology prevalence, sexual practices, implementing screening programs, determining vaccine cost-effectiveness, and ensuring quality screening and colposcopy.
This document discusses cervical cancer, its causes, prevention, and screening. Some key points:
- Cervical cancer is a major problem in India, with over 200 women dying from it daily.
- HPV infection is the main cause, with types 16 and 18 responsible for over 75% of cases.
- Screening through Pap smears and HPV testing can detect pre-cancerous lesions early and prevent cervical cancer by treating these lesions.
- Other prevention methods include the HPV vaccine.
- Colposcopy is used to examine the cervix in more detail if abnormal cells are found on screening.
The document summarizes the natural history and pathogenesis of HPV. It discusses the worldwide burden of cervical cancer, phylogenetic classification of HPV, and the viral lifecycle within host cells. Persistent infection with high-risk HPV types is required for progression from normal cervical epithelium to pre-cancerous lesions and eventually invasive cervical cancer, with the contribution of additional genetic mutations and external cofactors over long periods of time.
Cervical cancer is a major public health problem in Tanzania, where it is the leading cause of cancer death among women. Rates are projected to increase substantially by 2025 without intervention. Cervical cancer is caused by persistent infection with high-risk HPV types. Most cases progress through defined pre-invasive stages (CIN) over many years before becoming invasive cancer. Screening programs that detect and treat pre-invasive lesions provide an opportunity for prevention. Current treatments vary depending on cancer stage but often involve surgery, radiation, and chemotherapy. Widespread HPV vaccination and screening could substantially reduce cervical cancer incidence and mortality in Tanzania.
The document summarizes information about using mice as a model for studying breast development and breast cancer research. It discusses breast cancer statistics and risk factors in humans. It then describes the anatomy and histology of the human and mouse mammary glands, explaining why mice are a useful model. Some key reasons mentioned are that mouse and human breast tissue are comparable histologically and mice allow for genetic manipulation of the mammary glands. The document also outlines several approaches for inducing mammary tumors in mice, such as through chemical carcinogens, transgenic overexpression of oncogenes, or knockout of tumor suppressor genes. Finally, it briefly discusses human breast pathology and factors that predict breast cancer treatment outcomes.
Gestational trophoblastic disease includes complete and partial hydatidiform moles, invasive moles, choriocarcinoma, and placental site trophoblastic tumors, with molar pregnancies requiring surgical evacuation and strict follow up of beta HCG levels to monitor for malignant transformation into gestational trophoblastic neoplasia. Risk factors include extremes of maternal age, previous molar pregnancies, and ethnicity, while presentation is typically irregular bleeding and an enlarged uterus out of proportion to gestational age.
This document discusses HPV, its link to cervical cancer, and CERVAVAC, an indigenous HPV vaccine developed in India. It provides background on HPV, noting it is the most common STI and can cause several cancers including cervical cancer. It explains how HPV evades the immune system and its lifecycle in the cervix. It classifies HPV types as high-risk or low-risk and notes that high-risk HPV 16 and 18 cause over 70% of cervical cancer cases globally. It discusses cervical cancer signs, symptoms and prevention methods like education, screening via Pap tests, and vaccination. It provides an overview of CERVAVAC, India's first indigenous HPV vaccine, and its goal of being affordable and
Cervical cancer develops from the transformation zone of the cervix due to persistent HPV infection. Screening allows for early detection and treatment of pre-cancer to prevent progression to invasive cancer. Risk factors include early sexual activity, multiple partners, HIV/AIDS, and lack of screening. Screening tests can find pre-cancer which, if untreated, may develop into cancer over 10-20 years. Treatment options depend on stage, from simple hysterectomy for early stages to chemotherapy and radiation for late stages.
HUMAN PAPILLOMA VIRUS INFECTION & CERVICAL CANCER ABHIJIT BANIK
This document discusses cervical cancer, including its causes, risk factors, symptoms, and treatment/prevention. It notes that cervical cancer is caused by high-risk strains of the human papillomavirus (HPV), especially HPV 16 and 18. HPV works by integrating into the host cell's genome and inactivating tumor suppressor proteins, leading to uncontrolled cell growth. Screening and prophylactic vaccines can prevent most cases of cervical cancer.
Similar to Using Mobile Phones for Cervical Cancer Screening (20)
Insurance Patient Health Coordination ClickMedix 2015ClickMedix
ClickMedix provides a guided patient journey platform to help patients navigate the healthcare system and improve health outcomes. The platform uses a health scorecard to assess patients' conditions across multiple areas and provide personalized care plans and referrals. It aims to coordinate care both virtually through mobile apps and in person through care coordinators. This coordinated longitudinal approach could enhance the patient experience, increase treatment adherence, and demonstrate a return on investment through reduced costs and improved health metrics.
ClickMedix is a connected mHealth platform that enables healthcare organizations to serve more patients better, faster, and at lower costs. It has been deployed in 16 countries through over 90 sites addressing different diseases. ClickMedix provides case studies on scaling tele-dermatology, community-based care for low-income populations, and managing diabetic patients collaboratively with multiple specialists. The platform aims to improve access to care through task-shifting to nurses and community health workers while lowering costs.
ClickMedix Introduction and Case Studies 2014ClickMedix
ClickMedix enables health organizations to provide continuous and coordinated care to patients through mobile technologies while improving patient outcomes at lower costs.
mHealth Summit Presentation 2014: Reinventing the Dynamics of the Healthcare ...ClickMedix
Today’s “boomers” are driving change in the healthcare system. This [mHealth Summit 2014] session discusses how wearable, point-of-care, patient self-management and other emerging technologies will supplement the increasing demand on healthcare services and the decreasing number of providers. It will explore an array of related and other promising emerging trends and opportunities which aid seniors entering a hyper-connected world.
Extending US Healthcare Capacity with ClickMedixClickMedix
Mobile health and education delivery system can help healthcare providers do more with less resources. The solution utilizes mobile technologies to connect patients to doctors for teleconsultations to improve access and outcomes, especially in rural areas. This allows a single doctor to treat thousands of patients by working with community health workers. The system aims to enhance care for chronic diseases while reducing costs through remote monitoring, training, and digitization of health records. Early adopters saw benefits like increased patient volumes, faster treatments, and savings on transportation and personnel.
How to take pictures for teledermatology: remote diagnosis of dermatologic / ...ClickMedix
This presentation details how to photograph images for skin / dermatology conditions needed for a remote dermatologist to provide diagnosis and treatment advice.
This presentation details ClickMedix Telehealth platform functions and usages for health providers, medical students/residents, medical attendings, and specialists.
Mobile Telemedicine: Cervical Cancer Screening in BotswanaClickMedix
This study examined the use of mobile telemedicine for cervical cancer screening in Botswana. Nurse midwives performed visual inspection with acetic acid (VIA) on 95 HIV-positive women and took photographs of the cervix with a mobile phone. An expert gynecologist remotely diagnosed 64 of the photographs and found 82% agreement with positive nurse readings and 89% agreement with negative readings. Overall, nurse VIA and remote photographic inspection had 70-81% diagnostic agreement. The study suggests mobile telemedicine may improve access to cervical cancer screening in remote areas.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Debunking Nutrition Myths: Separating Fact from Fiction"AlexandraDiaz101
In a world overflowing with diet trends and conflicting nutrition advice, it’s easy to get lost in misinformation. This article cuts through the noise to debunk common nutrition myths that may be sabotaging your health goals. From the truth about carbohydrates and fats to the real effects of sugar and artificial sweeteners, we break down what science actually says. Equip yourself with knowledge to make informed decisions about your diet, and learn how to navigate the complexities of modern nutrition with confidence. Say goodbye to food confusion and hello to a healthier you!
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Giloy in Ayurveda - Classical Categorization and Synonyms
Using Mobile Phones for Cervical Cancer Screening
1. Mobile T elemedicine
& E ducation:
Use of mobile telemedicine for cervical cancer
screening – improving access to cancer
prevention for HI V+ women in B otswana
T ing Shih
CEO & Founder
http:clickmedix.com
3. HPV/HIV Co-Infection and Cervical Cancer
Prevention in Botswana
Slides adopted from:
Doreen Ramogola-Masire, MD
Country Director, Botswana-UPenn Partnership
University of Pennsylvania
4. Click to edit Master title style
Human papillomavirus (HPV)
• HPV is a relatively small virus containing circular double-
stranded DNA within a spherical shell (capsid)
• HPVs infect cutaneous epithelium (skin) and mucosal
epithelium (e.g. cervical and other anogenital mucosae)
55 nm
Slide courtesy of
Burd EM. Clin Microbiol Rev 2003; 16:1–17.
EXCCEL
5. Estimated numberedit Master title style (2002)
Click to of cases of cervical cancer
493,243 cases worldwide
North America Europe
14,670 59,931
Africa
78,897
South and Asia
Central America 265,884
71,862
< 9.2 < 16.1 < 26.2 < 32.6 < 87.3*
* per 100,000.
5 Ferlay J, et al. GLOBOCAN 2002 Cancer Incidence, Mortality and
Prevalence Worldwide. IARC CancerBase; Lyon, 2004.
6. Virtually all cervical cancers are caused
Click to editby HPV title style
Master
Global total HPV-attributable cancers in females, 2002
Attributable % all Attributable to
to HPV HPV HPV 16/18
cancer
Total in
Site % Cases % Cases
cancers females
Cervix 492,800 ~100 492,800 93.5 70+ 344,900
Vulva, vagina 40,000 40 16,000 3.0 80 12,800
Anus 15,900 90 14,300 2.7 92 13,100
Oropharynx 9,600 12 1,100 0.2 91 1,000
Mouth 98,400 3 2,900 0.6 97 2,800
Total 527,100 374,600
Slide courtesy of 6 Adapted from Parkin DM & Bray F. Vaccine 2006; 24(Suppl 3):S11–S25;
EXCCEL Walboomers JMM, et al. J P athol 1999; 18 9 : 12–19.
7. Click to edit Master title style
HPV lifecycle and immune evasion
Cervical HPV has many immune
canal evasion mechanisms:1
• Viral lifecycle occurs entirely
within epithelium
• No viraemia
Cervical
epithelium
• No cell death
• No inflammation
• Local immunosuppression caused
by viral proteins
• HPV ‘stealth’ and immune evasive mechanisms enable infection to persist1
• Persistent infection is a prerequisite2 but may not be enough alone –
co-factors may play an important role in progression to cervical cancer3,4
Slide courtesy of 1. Stanley M, et al. Vaccine 2006; 24S1:S1/16–S1/22; 2. Bosch FX, et al. J Clin Pathol 2002; 55:244–265;
EXCCEL
7
3. Ho GY, et al. N Engl J Med 1998; 338:423–428; 4. Richardson H. Cancer Epidemiol Biomarkers Prev 2003;
12:485–490.
9. Botswana
Click to edit Master title style
HIV prevalence = 24.8% (ages 15–49)
HIV modifies the natural history of HPV infection
HIV-infected vs. non-HIV infected women more likely to
have:
Persistent high-risk HPV infection
Multiple HPV infections
Precancer and ca cx earlier age/more rapid development
High recurrence rates of treated lesions
ART does not necessarily alter precancer/ca cx course
UNAIDS (2010) 'UNAIDS report on the global AIDS epidemic‘; http://www.unaids.org/globalreport/Global_report.htm
11. Linear Increase in Cervicaltitle style
Click to edit Master Cancer Cases
Botswana National Cancer Registry 1998-2008
12. Higher Clickof Cervical Cancertitle style
Risk to edit Master for HIV+ Patients
Botswana National Cancer Registry 1998-2008
13. Clinical Spectrum OfMaster title style
Click to edit HPV and Cervical Cancer
Peak Ages: 15-25 25-35 45-50
Schiffman et al., Lancet, 2007
14. Major steps in development
Click to edit Master title style
of cervical cancer
Infection with HPV
Persistent infection over 2-5yrs
may progress to pre-cancer
SCREEN AND TREAT
PRECANCER
Pre-cancer may
progress to invasive
cancer
Slide courtesy of Dr. Carla Chibwesha
15. Cervical cytology Master title style
Click to edit (Pap smear) screening
1. Woman aware of need for screening
2. Access to provider with supplies
3. Provider trained to take adequate specimen
4. Transport specimen to cytology lab
5. Cytology lab services
6. Report generated then sent to clinic
7. Clinic is able to report results to woman
16. Pap Smear to edit Master times-Botswana
Click Screening: Wait title style
1.
2.
Pap 3.
test + Colposcopy
& Return
Biopsy for
test - biopsy test + 4.
(confirm & results
diagnose) Treatment
test -
6 weeks 2-4 months 4-6 weeks 3-5 months
Loss to follow up Loss to follow up Loss to follow up Loss to follow up
TOTAL WAIT to complete treatment = 7 ½ to 12 MONTHS
Slide courtesy of Sara Forhan,,CDC
18. Click to edit Master title style
Courtesy: Kelley Quinley
19. VisualClick to edit Master title style with
Inspection After Acetic Acid (VIA)
Enhanced Digital Imaging
Courtesy: Ann Steiner
20. Click to edit Master title style
VIA Strengths and Limitation
Strengths:
Very well accepted by health workers and women
Simple; immediate result, very suitable for single-visit—”screen-
and-treat” (with cryotherapy) approach
Requires only acetic acid, a speculum, and a light source (torch)
Can be performed by nurses and midwives
Single visit approaches using VIA once a lifetime cost less and
reduce CaCx by 26% compared with no screening
Limitations:
Sensitivity is not optimal, but is similar or better than Pap
Slide courtesy of Dr. Jose Jeronimo, PATH
23. Photographic Inspection withtitle style (PIA)
Click to edit Master Acetic Acid
August 2009 in Gaborone, Botswana (18+ years old, HIV+, non-pregnant with no prior procedures)
Speculum exam with an endocervical swab to obtain cells for HPV testing
A nurse midwife used forceps to soak a cotton ball in 4% acetic acid applied to cervix and vaginal
fornices for three minutes. The cervix was then examined for acetowhite lesions using standard VIA.
Images were transmitted by MMS and stored to be evaluated by the same nurse midwife who
performed the VIA examination 3months after initial visit, and blinded to her original evaluation.
Subjects deemed VIA-positive were treated at the same visit with cryotherapy in the ‘see-and-treat’
model of care. In cases where the lesions occupied over 75% of the cervix, could not be fully
visualized, or were suggestive of invasive carcinoma, referral was made to a tertiary medical center
for treatment by loop electrosurgical excision procedure (LEEP) or cervical cone biopsy.
HPV genotyping of ThinPrep endocervical samples was performed using Gold Taq to evaluate the
presence of 32 different genotypic HPV strains
24. Click to edit Master title style
Images from Camera Phone (5 megapixel with zoom)
Cervical photographs taken with the Samsung SGH-900 mobile
phone with zoom function and hand-held LED flashlight light
source.
A: Healthy cervix B: Cervix with acetowhite lesion
A B
25. Click to editResults title style
Master
VIA and detection of HPV:
92% of VIA-positive women were infected with at least one strain of high-risk
HPV
47% of subjects infected with high-risk HPV subtypes tested positive with VIA
PIA results:
Nurse VIA and PIA showed overall 81% diagnostic concordance (2 out of 4
nurses showed 100% concordance with women’s health expert
89% of negative expert PIA readings were determined to be negative by
nurse PIA
82% of positive expert PIA readings were determined to be positive by nurse
PIA
Nurses and experts agreed more often than expected by chance (P<0.001),
kappa statistic (0.7)
Estimated number of cases of cervical cancer (2002) The global distribution of cervical cancer cases per 100,000 individuals is shown, based on GLOBOCAN data from 2002. Reference Ferlay J, et al. GLOBOCAN 2002 Cancer Incidence, Mortality and Prevalence Worldwide. IARC CancerBase; Lyon, 2004 .
Virtually all cervical cancers are caused by HPV 99.7% of cervical cancer cases are attributable to HPV. Cervical cancer accounts for 93.5% of all HPV-related cancer globally, and over 70% of this type of cancer is caused by HPV 16 and 18. Vulval, vaginal, anal, oropharyngeal and mouth cancers combined account for 6.5% of all HPV cancer. Note that for cancers of the vulva, vagina, anus, oropharynx and mouth, a greater range in the percentage of cases attributable to HPV has been reported elsewhere. Munoz and colleagues (2006) reported that approximately 60–90% of vulval and vaginal cancers, 88–94% of anal cancers, 36% of oropharyngeal cancers (range 11–100%) and 24% of mouth cancers (range 4–80%) are HPV positive. References Parkin DM & Bray F. Vaccine 2006; 24 (Suppl 3) : S11. Mu ñ oz N, et al. Vaccine 2006; 24 (Suppl 3) : S1. Walboomers JMM, et al. J Pathol 1999; 189: 12–19.
The virus is thought to infect the basal cell layer of the epithelium via microabrasions. It then uses the host cell machinery to replicate viral DNA and express virally encoded proteins. Finally, new virus particles are assembled in the upper layers of the epithelium and virus is released with the cells as they are shed from the epithelial surface. HPV lifecycle and immune evasion HPV has several mechanisms for avoiding the immune system. HPV infects and multiplies in basal cells of the epithelial layer, which have a naturally short lifespan. HPV does not replicate in the blood (no viraemia) and the infection is not spread systemically. As a result, HPV does not need to destroy the host cell and, in the absence of cell death or a danger signal, HPV fails to trigger inflammation and an immune response. In addition, HPV downregulates the expression of interferon genes. Type 1 interferons are cytokines that have antiviral and antiproliferative properties, and HPV oncoproteins E6 and E7 can directly inhibit these antiviral pathways in the cell. Reference Stanley M. Vaccine 2006; 24: S16–22.