In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strat...In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strategies:human papillomavirus(HPV)vaccination,cervical cancer screening,and treatment of precancerous lesions and cancer.Subsequently,the WHO and its partners developed a global strategy to accelerate the reduction of cervical cancer incidence,with an ultimate goal of achieving elimination within the next century.This Global Strategy represents a formal international commitment and is anchored in the 90-70-90 targets to be achieved by 2030.In parallel,several countries have also set national commitments,such as Sweden's pledge to achieve elimination by 2027 and Australia's target of achieving elimination by 2035.展开更多
As the 30th anniversary of the landmark Beijing Fourth World Conference on Women approaches,the forthcoming 2025 World Women's Summit in Beijing offers a timely platform to reaffirm commitments to women's well...As the 30th anniversary of the landmark Beijing Fourth World Conference on Women approaches,the forthcoming 2025 World Women's Summit in Beijing offers a timely platform to reaffirm commitments to women's well-being worldwide.In alignment with this milestone,Cancer Biology&Medicine is proud to present this special issue dedicated to accelerating the global elimination of cervical cancer.展开更多
Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical ca...Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical cancer as a major public health problem.Methods All data were extracted from the Global Cancer Observatory(GLOBOCAN)2022.Age-standardized incidence rate(ASIR)and mortality rates(ASMR)of cervical cancer were compared and linked to Human Development Index(HDI)between populations.The estimated annual percentage changes(EAPCs)were used to characterize the temporal trend in ASIR/ASMR,and demographic estimates were projected up to 2050.Results Globally,an estimated 662,044 cases(ASIR:14.12/100,000)and 348,709 deaths(ASMR:7.08/100,000)from cervical cancer occurred in 2022,corresponding to the fourth cause of cancer morbidity and mortality in women worldwide.Specifically,42%of cases and 39%of deaths occurred in China(23%and 16%)and India(19%and 23%).Both ASIR and ASMR of cervical cancer decreased with HDI,and similar decreasing links were observed for both early-onset(0–39 years)and late-onset(≥40 years)cervical cancer.Both ASIR and ASMR of overall cervical cancer showed decreasing trends during 2003–2012(EAPC:0.04%and-1.03%);however,upward trends were observed for early-onset cervical cancer(EAPC:1.16%and 0.57%).If national rates in 2022 remain stable,the estimated cases and deaths from cervical cancer are projected to increase by 56.8%and 80.7%up to 2050.Moreover,the projected increase of early-onset cervical cancer is mainly observed in transitioning countries,while decreased burden is expected in transitioned countries.Conclusions Cervical cancer remains a common cause of cancer death in many countries,especially in transitioning countries.Unless scaling-up preventive interventions,human papillomavirus(HPV)vaccination and cervical cancer screening,as well as systematic cooperation within government,civil societies,and private enterprises,the global burden of cervical cancer would be expected to increase in the future.展开更多
This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in...This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in quality of life can significantly impact patients’lives.Currently,most treatments are supportive,with no specific treatment options available in Western medicine.Non-Western medicine,often less toxic and easier to administer,has shown promising results when used alongside radiotherapy for cervical cancer.Despite these potential benefits,challenges such as limited evidence and restricted application areas persist.While non-Western medicines may offer potential improvements in chemoradiotherapy outcomes for cervical cancer,further research is necessary to substantiate these benefits.展开更多
BACKGROUND Cervical cancer is a formidable global health issue,particularly affecting women in lower-middle-income countries with little or no access to preventative vaccines,screening programs,and treatment modalitie...BACKGROUND Cervical cancer is a formidable global health issue,particularly affecting women in lower-middle-income countries with little or no access to preventative vaccines,screening programs,and treatment modalities.The case report presents a unique case of a large cervical cancer achieving complete response(CR)with concurrent chemoradiotherapy(CCRT),highlighting the effectiveness of this treatment approach even in advanced stages and underscoring the importance of adaptive radiotherapy(RT)in optimizing patient outcomes.CASE SUMMARY We present the case of a 53-year-old woman who presented with four years of abnormal vaginal bleeding and was found to have p16-positive,moderately differentiated cervical squamous cell carcinoma.The tumor measured 14 cm×12 cm×8 cm,the largest size reported in the literature to achieve CR with CCRT.Despite this monumental feat,the patient remained disease-free and is currently on follow-up for 2 years;however,she continued to suffer from substantial morbidity caused by a vesicovaginal fistula and hydronephrosis,underscoring the continuing impact of cervical cancer on quality of life.CONCLUSION In this case report,we highlight the effectiveness of CCRT in achieving CR,even in cases of bulky cervical cancer,with adaptive RT offering a customized strategy to improve patient outcomes.We also emphasize the necessity for multidisciplinary team discussions and highlight the need for strategies to mitigate treatment-related toxicities and long-term complications.展开更多
Objective:Cervical cancer is a growing concern in China,especially among women who reside in rural areas and older women.Understanding age-and region-specific trends in cervical cancer is vital for informing policy an...Objective:Cervical cancer is a growing concern in China,especially among women who reside in rural areas and older women.Understanding age-and region-specific trends in cervical cancer is vital for informing policy and assessing progress toward WHO elimination targets.Methods:The 2000±2020 data from 22 long-standing registries contributing to the China national cancer registry was analyzed to estimate age-standardized incidence and mortality rates(ASIR and ASMR,respectively).Joinpoint regression yielded an average annual percentage change(AAPC)stratified by age group(<35,35±64,65±74,and≥75 y)and by urban-rural area.The comparative analysis included GLOBOCAN Overtime data from selected Asia-Pacific countries.Results:The ASIR tripled in China between 2000 and 2020 before stabilizing(AAPC=6.5%),while the ASMR rose steadily(AAPC=3.9%).The urban incidence declined after 2009 among women<35 y,while rural trends were broadly stable.The ASIR and ASMR increased in urban areas among women 35±64 y of age,while rural areas had a rising ASIR and a stable ASMR,suggesting potential screening effects.In contrast,women≥65 y of age had a steadily increasing incidence and mortality in rural and urban areas.Australia and Republic of Korea had consistent declines in the ASIRs and ASMRs compared to other Asia-Pacific countries,whereas Japan exhibited rising trends.The Philippines experienced a surge in mortality rates,despite incidence rates remaining stable or declining.Conclusions:The cervical cancer burden in China has begun to plateau but large disparities persist by age and geography.To achieve elimination of cervical cancer,it is imperative to implement tailored strategies that prioritize the urgent expansion of HPV vaccination programs,the deployment of high-efficacy screening methods,and the universal access to treatment throughout the nation.展开更多
To many people,especially women at the Mzuzu Central Hospital(MCH)in the Northern Region of Malawi,Du Shumin is a familiar and respected name.This is because of her expertise in cervical cancer treatment and the many ...To many people,especially women at the Mzuzu Central Hospital(MCH)in the Northern Region of Malawi,Du Shumin is a familiar and respected name.This is because of her expertise in cervical cancer treatment and the many women,some of whom never dreamed of living a normal life again,that Du has helped.展开更多
In the article“LncRNA PCGEM1 facilitates cervical cancer progression via miR-642a-5p/KIF5B axis”(Oncology Research,2024,Vol 32,No.7,pp.1221-1229.doi:10.32604/or.2024.047454),there were some errors in the content.In ...In the article“LncRNA PCGEM1 facilitates cervical cancer progression via miR-642a-5p/KIF5B axis”(Oncology Research,2024,Vol 32,No.7,pp.1221-1229.doi:10.32604/or.2024.047454),there were some errors in the content.In order to ensure the scientific and rigorous nature of our academic publications,we deleted the incorrect content that is not related to this study,supplemented the details of the method.展开更多
Introduction Progress toward the global elimination of cervical cancer as a public health concern remains slow and highly uneven across countries.High-income nations such as Australia and FinlandDboth of which have ac...Introduction Progress toward the global elimination of cervical cancer as a public health concern remains slow and highly uneven across countries.High-income nations such as Australia and FinlandDboth of which have achieved high human papillomavirus(HPV)vaccination coverage and implemented quality-assured cervical cancer screening programs-have successfully decreased the incidence rates to below 8 cases per 100,000 women~1.These countries are on track to reach the elimination threshold of fewer than 4 cases per 100,000 women within the next few years,as defined by the World Health Organization(WHO).展开更多
BACKGROUND Currently,there is limited research examining the relationship between anxiety,depression,coping styles,and illness uncertainty in patients with cervical cancer(CC)undergoing radiotherapy.Addressing this ga...BACKGROUND Currently,there is limited research examining the relationship between anxiety,depression,coping styles,and illness uncertainty in patients with cervical cancer(CC)undergoing radiotherapy.Addressing this gap could provide valuable insights and more reliable evidence for clinical practice targeting this patient population.AIM To analyze the anxiety,depression,and coping styles of patients with CC undergoing radiotherapy and explore their correlations with illness uncertainty.METHODS A total of 200 patients with CC undergoing radiotherapy at The First Affiliated Hospital of Soochow University between June 2018 and June 2022 were enrolled.Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale(HADS),comprising subscales for anxiety(HADS-A)and depression(HADS-D).Coping styles were evaluated using the Jalowiec Coping Scale(JCS-60),comprising dimensions such as confrontive,evasive,optimistic,fatalistic,emotive,palliative,supportive,and self-reliant.Illness uncertainty was measured using the Mishel Uncertainty in Illness Scale(MUIS),encompassing ambiguity,complexity,information deficit,and unpredictability.Correlations among anxiety,depression,coping styles,and illness uncertainty were analyzed.RESULTS During radiotherapy,the mean scores were 7.12±3.39 for HADS-A,6.68±3.49 for HADS-D,1.52±0.23 for JCS-60,and 93.40±7.44 for MUIS.Anxiety(HADS-A≥8)was present in 39.5%of patients,depression(HADS-D≥8)in 41.0%,and both in 14.0%.Anxiety was significantly positively correlated with ambiguity,unpredictability,and total MUIS score(P<0.05).Depression was significantly positively correlated with ambiguity,information deficit,unpredictability,and total MUIS score(P<0.05).Most patients adopted an optimistic coping style,whereas the emotive style was least utilized.Evasive,fatalistic,and emotive coping styles were significantly positively correlated with illness uncertainty,whereas the self-reliant style was significantly negatively correlated with unpredictability(P<0.05).CONCLUSION Anxiety,depression,and coping styles in patients with CC undergoing radiotherapy correlate significantly with their level of illness uncertainty.Medical staff should address patients’psychological status and coping strategies by providing targeted information to reduce negative emotions,foster adaptive coping styles,and decrease illness uncertainty.展开更多
Objective:To investigate the effects of arecoline on HPV-positive cervical cells and unveil its underlying mechanism in cervical carcinogenesis.Methods:The cytotoxicity of arecoline was determined and the effect of su...Objective:To investigate the effects of arecoline on HPV-positive cervical cells and unveil its underlying mechanism in cervical carcinogenesis.Methods:The cytotoxicity of arecoline was determined and the effect of subtoxic concentrations of arecoline on the expression of viral oncoproteins and transcriptional factors was examined in CaSki and SiHa cells.HPV16 promoter activity was evaluated in a plasmid containing HPV16 long control region(pGL3-HPV16LCR)-transfected cells.Cell proliferation,cell migration,and number of colonies were assessed by MTT,wound healing assay,and colony-forming assay,respectively.Results:Arecoline at 0.01μg/mL significantly upregulated HPV16 E6 and E7 oncoproteins in both CaSki and SiHa cells.It also upregulated the expression level of c-Fos and c-Jun mRNAs,and c-Myc protein in CaSki and SiHa cells.In addition,arecoline at subtoxic concentrations(0.0025 and 0.01μg/mL)significantly induced HPV16 promoter activity in pGL3-16LCR-transfected cells.It also promoted SiHa and CaSki cell proliferation,migration,and colony formation.Conclusions:Arecoline at subtoxic concentrations promotes the proliferation,migration,and colony formation of CaSki and SiHa cells via upregulation of c-Fos,c-Jun,c-Myc,and HPV16 E6 and E7 expressions.展开更多
BACKGROUND Cervical cancer is a prevalent form of cancer affecting women worldwide and it is the second most common cancer among women in Indonesia,accounting for 8.5%of all cancer-related deaths.Cervical cancer progr...BACKGROUND Cervical cancer is a prevalent form of cancer affecting women worldwide and it is the second most common cancer among women in Indonesia,accounting for 8.5%of all cancer-related deaths.Cervical cancer progression can be evaluated through laboratory tests to detect anaemia,an increased platelet count,and elevated inflammatory markers,therefore,effective laboratory examination is crucial for early detection and treatment of cervical cancer.AIM To evaluate the association between laboratory findings(haematology,haematology index,and inflammatory index)and the clinical stage of cervical cancer.METHODS This cross-sectional study analyzed adult cervical cancer patients’data from medical records and laboratory results including sociodemographic status,histopathological finding,clinical stage,and complete haematology examination.Numerical data was analyzed by the one-way ANOVA(normal data distribution),while the Kruskal-Wallis test was used for non-parametric data(abnormal distribution),followed by appropriate post-hoc analysis.The categorical data was analyzed by the Chi-square or Fisher Exact tests.The significance level was established at a P value<0.05.RESULTS This study involved the data of 208 adult cervical cancer patients and found no association between age,marital history,parity history,hormonal contraceptive use and cervical cancer stages.There were significant differences in the clinical laboratory test results based on the clinical stage of cervical cancer,including haemoglobin levels(P<0.001),leucocytes(P<0.001),neutrophils(P<0.001),monocytes(P=0.002),lymphocytes(P=0.006),platelets(P<0.001),neutrophil-lymphocyte ratio/NLR(P<0.001),lymphocyte-monocyte ratio/LMR(P<0.001),and plateletlymphocyte ratio/PLR(P<0.001).There were also significant differences in the systemic inflammatory index(SII)and systematic inflammatory response index(SIRI)between stage III+IV cervical cancer and stage II(SII P<0.001;SIRI P=0.001)and stage I(SII P<0.001;SIRI P=0.016),associated with the shifts in previously mentioned complete haematological values with cancer advancement.CONCLUSION The haematological parameters,inflammatory haematological ratios,and inflammatory indices exhibited significant differences between cervical cancer stages,therefore these tests can be utilized to evaluate cervical cancer progression.展开更多
BACKGROUND Cervical cancer is a significant health concern among females in perimenopause,with a high prevalence of depression in this population.The rationale for this study was to explore the risk factors associated...BACKGROUND Cervical cancer is a significant health concern among females in perimenopause,with a high prevalence of depression in this population.The rationale for this study was to explore the risk factors associated with depression in patients in perimenopause with cervical cancer.We hypothesized that socioeconomic status,disease characteristics,and quality of life factors contributed to the development of depression in these patients.AIM To investigate the risk factors associated with depression in patients in perimenopause with cervical cancer.METHODS A retrospective study was conducted on 254 patients in perimenopause with cervical cancer admitted to a single center.Patients were divided into a nondepression group(n=152)and a depression group(n=102)based on whether depression occurred after treatment.Data collection included demographic,clinical,and psychosocial factors.The Hamilton Depression Rating Scale was used to assess depression.Logistic regression analysis was performed to identify risk factors.RESULTS Patients with depression more often had low income(<4000 China yuan:66.7%vs 6.6%,P<0.001),initial disease onset(70.6%vs 57.2%,P=0.001),low social support(70.6%vs 55.3%,P=0.014),pathological stages III-IV(70.6%vs 41.5%,P<0.001),high pain level(65.7%vs 34.2%,P<0.001),and poor sleep quality(67.6%vs 32.2%,P<0.001).Logistic regression identified low income[odds ratio(OR)=32.606,P<0.001],initial disease onset(OR=4.282,P=0.001),pathological stages III-IV(OR=4.123,P=0.0005),high pain level(OR=1.181,P=0.0000434),and poor sleep quality(OR=3.094,P=0.0041)as key risk factors.CONCLUSION Low income,initial onset,low support,advanced stages,high pain,and poor sleep quality increased depression risk in patients in perimenopause with cervical cancer.Studies investigating interventions for this population are needed.展开更多
Objective:Cervical cancer remains a global health challenge with substantial disparities between countries.High-quality colposcopy is essential for cervical cancer prevention,yet training opportunities remain inadequa...Objective:Cervical cancer remains a global health challenge with substantial disparities between countries.High-quality colposcopy is essential for cervical cancer prevention,yet training opportunities remain inadequate worldwide.We developed the Intelligent Digital Education Tool for Colposcopy(iDECO)to address training gaps and evaluated the effect across diverse international settings.Methods:Six pre-post interventional training programmes were conducted in China,Mexico,and Mongolia from December 2024 to May 2025.A total of 369 trainees from 87 centers participated in a 3-week online training programme using iDECO,a bilingual webbased platform featuring authentic colposcopy cases,gamified learning pathways,and personalized analytics.The primary outcomes included colposcopy competence in general assessment,colposcopic findings,diagnostic accuracy,and management decisions.The secondary outcomes focused on participant feedback and satisfaction.Results:Of 369 participants who completed pretests,333(90.24%)completed post-training assessments.Significant improvements were observed across all competency domains.Diagnostic accuracy increased with an odds ratio(OR)of 1.72(95%CI:1.60±1.86)with the greatest gains in high-grade lesion identification[OR=2.27(95%CI:1.94±2.64)].Squamocolumnar junction visibility and transformation zone type assessments improved with ORs of 1.41(95%CI:1.31±1.51)and 1.87(95%CI:1.73±2.01),respectively.Biopsy decision-making accuracy also showed significant improvement[OR=2.09(95%CI:1.91±2.29)].International participants showed lower baseline performance but achieved the greatest improvements.Greater than 85%of participants rated the training highly satisfactory and 83.56%preferred intelligent training over traditional methods.Conclusions:iDECO-based training significantly improved colposcopy competence across diverse international settings with high user satisfaction.These findings support the potential for worldwide implementation of intelligent digital training tools to address colposcopy training gaps and contribute to the elimination of cervical cancer.展开更多
BACKGROUND Cervical cancer is the most commonly diagnosed cancer worldwide and the most common cancer in females living with human immunodeficiency virus(HIV).Cervical cancer is classified as an acquired immune defici...BACKGROUND Cervical cancer is the most commonly diagnosed cancer worldwide and the most common cancer in females living with human immunodeficiency virus(HIV).Cervical cancer is classified as an acquired immune deficiency syndrome-defining disease.Brain metastases(BMs)from cervical cancer are extremely rare,with an incidence rate of approximately 0.63%,and there is limited information on optimal treatment protocols and patient outcomes.Since brain lesions are sequestered behind the blood-brain barrier,multimodal treatment approaches are crucial to help improve the prognosis of cervical cancer in patients with BMs who are also living with HIV.CASE SUMMARY A 42-year-old Chinese female with HIV infection was diagnosed with stage IIIC1r cervical cancer in March 2022 based on the International Federation of Gynecology and Obstetrics system.Fourteen months after undergoing the initial treatment with concurrent chemotherapy and radiotherapy in January 2024,the patient presented to a local hospital with a severe explosive headache.The patient underwent craniotomy and postoperative pathological examination confirmed metastasis of cervical squamous cell carcinoma to the brain on February 1,2024.Following surgery,the patient received external beam radiotherapy for the metastatic lesions.The patient has been under observation for 7 months with no evidence of tumor recurrence.CONCLUSION Females living with HIV are more than three times more likely to be diagnosed with cervical cancer.Due to the scarcity of cervical cancer BMs,therapeutic protocol experience is limited.In addition to the existence of the blood-brain barrier,the treatment of cervical cancer BMs appears to be exceptionally complex,and a multi-modal treatment approach consisting of chemotherapy,surgery,and radiation may help prolong patients’life.For females living with HIV,antiretroviral therapy should be prioritized,as recommended by the Center for Disease Control in China.An intact immune system and a high CD4+count are positive indicators of treatment response and tumor reduction.The overall survival of patients with cervical cancer after brain metastasis is approximately 3-5 months.However,owing to multimodal therapy and the use of antiretroviral therapy,the patient reported in this case showed no signs of recurrence after prolonged follow-up.展开更多
Objective:To describe temporal changes associated with deployment of an optical character recognition(OCR)-enabled OneIdentity(One-ID)digital platform for rural cervical cancer screening,focusing on over-screening rat...Objective:To describe temporal changes associated with deployment of an optical character recognition(OCR)-enabled OneIdentity(One-ID)digital platform for rural cervical cancer screening,focusing on over-screening rates,CIN2+detection,colposcopy follow-up,and CIN2+management.Methods:A multi-county pre-post observational study was conducted in six rural counties in Shanxi,Yunnan,and Sichuan Provinces(2021±2024),encompassing 153,978 encounters.The digital platform integrates OCR identity capture,deterministic One-ID linkage,and real-time duplicate alerts.Over-screening proportions before and after digital deployment were compared,changes in CIN2+detection rate were evaluated,and colposcopy follow-up and CIN2+management were assessed.Differences were tested withχ2 or Fisher's exact tests.Results:Among 153,978 encounters,the proportion of over-screening decreased from 12.64%in 2023 to 0.17%in 2024 with an absolute reduction of 12.17%(95%CI:11.94±12.40;P<0.001).The share of women receiving a first screening within the preceding 3 y increased from 78.3%to 88.2%(P<0.001).Colposcopy completion improved from 64.1%to 84.9%.The CIN2+detection rate rose from 0.35%(2021±2023 pooled)to 0.67%in 2024(P<0.001)and CIN2+management completion increased from 56.0%to 76.2%(95%CI:13.3±27.2;P<0.001).These improvements were consistent across age groups,counties,and screening strategies.Conclusions:The OCR-enabled One-ID platform substantially reduced over-screening,increased CIN2+detection rate,and strengthened case follow-up/management,particularly where baseline tracking was weak,supporting scalable digital reinforcement of rural screening programmes.展开更多
Objective:Anillin(ANLN)is considered an oncogene in various cancers,but its effect on cervical cancer remains poorly understood.Hence,this study aimed to describe the action of ANLN on cervical cancer development and ...Objective:Anillin(ANLN)is considered an oncogene in various cancers,but its effect on cervical cancer remains poorly understood.Hence,this study aimed to describe the action of ANLN on cervical cancer development and investigate the potential mechanism.Methods:Analysis of ANLN expression and its association with survival in carcinoma and endocervical adenocarcinoma(CESC)patients based on GEO and UALCAN databases.The tumor and adjacent normal tissues of 100 cervical cancer cases were harvested to detect the ANLN expression and explore its relationship with patient survival.Cell proliferation,apoptosis,migration,and invasion were measured by utilizing 5-ethynyl-2′-deoxyuridine(EdU)staining,Flow cytometry,and Transwell assay,respectively.ANLN andWnt expression were analyzed by RT-qPCR andWestern Blot.Results:ANLN was significantly elevated in tumor tissues,and cervical cancer cases with high ANLN expression exhibited poor survival and high dead proportion.Besides,ANLN induced cervical cancer cell proliferation,migration,and invasion and restrained cell apoptosis.In addition,ANLN promoted Wnt/β-catenin pathway activation.Furthermore,ANLN accelerated cell aggressive behaviors and suppressed cell apoptosis via activating the Wnt/β-catenin signaling in cervical cancer.Conclusion:ANLN was enhanced in cervical cancer tissues and related to poor prognosis.ANLN accelerated cervical cancer cell aggressive behaviors and suppressed cell apoptosis via activating theWnt/β-catenin pathway.展开更多
Cervical cancer remains a significant public health challenge,particularly in lowand middle-income countries.Screening of cervical cancer is crucial because it can detect precancerous changes and early-stage cancer.Re...Cervical cancer remains a significant public health challenge,particularly in lowand middle-income countries.Screening of cervical cancer is crucial because it can detect precancerous changes and early-stage cancer.Regard to the screening methods,combination of human papillomavirus(HPV)testing and cytological examination has superior sensitivity and specificity compared to cytology alone.Thus,recent guidelines recommend this combined approach instead of cytology alone to reduced cervical cancer incidence and mortality.By using this combination,HPV testing identifies high-risk strains associated with cervical cancer,while cytology helps detect abnormal cellular changes.This dual strategy enhances early detection rates,allowing for timely intervention and treatment.Moreover,recent studies demonstrated that this screening strategy also significantly reduced detection costs,indicating the potential for this screening strategy to be promoted,especially in economically constrained regions.Despite challenges in screening,such as accessibility,public awareness,and cultural attitudes,educating communities on the importance of HPV testing and cytology can improve participation rates.Overall,a combined HPV testing and cytology screening strategy represents a proactive approach to cervical cancer prevention,promising to save lives through early detection and treatment.展开更多
Objective:To evaluate the impact of government-organized screening on the economic burden among patients with cervical cancer and precancerous lesions,and explore mediating pathways across diagnosis,initial treatment,...Objective:To evaluate the impact of government-organized screening on the economic burden among patients with cervical cancer and precancerous lesions,and explore mediating pathways across diagnosis,initial treatment,radiotherapy/chemotherapy,follow-up,and recurrence/progression/metastasis.Methods:A multicentre,nationwide survey across 5 disease courses was conducted from 26 hospitals in China.Multivariable regression and structural equation modeling were used to assess the effects of government-organized screening on economic burden by comparing government-organized screening with workplace check-up,self-paid check-up,and symptom-based detection.Results:Workplace check-up,self-paid check-up,and symptom-based detection were associated with progressively higher costs across diagnosis[β:1.10,95%confidence interval(CI):0.54±1.67;β:1.46,95%CI:1.00±1.92;andβ:1.68,95%CI:1.25±2.11,respectively],initial treatment(β:0.36,95%CI:0.18±0.55;β:0.51,95%CI:0.35±0.66;andβ:0.56,95%CI:0.42±0.70,respectively),and follow-up(β:0.63,95%CI:0.38±0.88;β:0.83,95%CI:0.61±1.04;andβ:0.85,95%CI:0.65±1.06,respectively)compared to government-organized screening(all P<0.05).Earlier clinical staging and greater use of lower-level hospitals mediated 44.74%±54.97%of cost differences in diagnosis,73.27%±85.04%in initial treatment,and 30.38%±54.73%in follow-up.Fifteen percent of the cost differences during initial treatment were related to lower overtreatment for precancerous lesions.Conclusions:Government-led cervical cancer screening was associated with lower economic burden with pathways involving earlier-stage diagnosis,reduced overtreatment,and decreased reliance on higher-level hospitals,suggesting potential clinical benefits,efficient resource use,and improved equity in cancer care.展开更多
Background: Early research describing the concept of intensity-modulated conformal radiotherapy (IMRT) was based on 7 to 9 beams to reach an adequate level of modulation. Nevertheless, its implementation demands signi...Background: Early research describing the concept of intensity-modulated conformal radiotherapy (IMRT) was based on 7 to 9 beams to reach an adequate level of modulation. Nevertheless, its implementation demands significant resources. Our objective was to compare the compliance and homogeneity of target dose distribution between simplified IMRT and 3D-CRT in patients with cervical cancer and to assess the clinical value of simplified IMRT. Materials and Methods: From 2016 to 2017, 17 patients with stage IIB - IIIC cervical cancer were treated with external beam radiotherapy using simplified IMRT (12 cases) or 3DCRT (05 cases) and brachytherapy. Prior to radiotherapy, CT scans were conducted to delineate the target volume. The clinical target volume (CTV) included the uterus, primary tumor, supravaginal portion of the cervix, paracervical tissue, common iliac, internal and external iliac lymph nodes, obturator, and pre sacral lymph nodes, and the surrounding tissues. If the lower vagina was involved, the target volume included the whole vagina. The planning target volume (PTV) included the CTV with 1 cm anteriorly and 0.5 cm in all other directions. The PTV received 95% of 45 Gy (1.8 Gy/25 fraction). Dose-volume histogram, conformity index, homogeneity index, and treatment time per fraction were compared. Results: The 3D-CRT plan was more homogeneous than the simplified IMRT plan, while the simplified IMRT plan was more conformal. The volume of small bowels that received high-dose radiation significantly increased with simplified IMRT compared to 3D-CRT. Treatment time per fraction was 6 and 13 minutes for 3D-CRT and simplified IMRT, respectively. Conclusion: The simplified IMRT treatment plan is technically and dosimetrically acceptable and an alternative to the classic 3D-CRT plan for cervical cancer. It provides better dose distribution than 3D-CRT. However, the 3D-CRT treatment plan significantly reduced the overall treatment time per fraction.展开更多
基金supported by the CAMS Innovation Fund for Medical Sciences(No.2023-I2M-3-019)National Natural Science Foundation of China(No.82404366)。
文摘In May 2018,the Director-General of the World Health Organization(WHO)called for global action to eliminate cervical cancer~1.This call marked the beginning of an ambitious international effort to scale up 3 key strategies:human papillomavirus(HPV)vaccination,cervical cancer screening,and treatment of precancerous lesions and cancer.Subsequently,the WHO and its partners developed a global strategy to accelerate the reduction of cervical cancer incidence,with an ultimate goal of achieving elimination within the next century.This Global Strategy represents a formal international commitment and is anchored in the 90-70-90 targets to be achieved by 2030.In parallel,several countries have also set national commitments,such as Sweden's pledge to achieve elimination by 2027 and Australia's target of achieving elimination by 2035.
文摘As the 30th anniversary of the landmark Beijing Fourth World Conference on Women approaches,the forthcoming 2025 World Women's Summit in Beijing offers a timely platform to reaffirm commitments to women's well-being worldwide.In alignment with this milestone,Cancer Biology&Medicine is proud to present this special issue dedicated to accelerating the global elimination of cervical cancer.
基金supported by the National Key R&D Program of China(grant number:2021YFC2500400)National Natural Science Foundation of China(grant numbers:82172894,82073028,82204121)China Postdoctoral Science Foundation(grant number:2023M742617).
文摘Background Cervical cancer is the only cancer that can be eliminated worldwide.Tracking the latest burden of cervical cancer is critical toward the targets set by World Health Organization(WHO)to eliminate cervical cancer as a major public health problem.Methods All data were extracted from the Global Cancer Observatory(GLOBOCAN)2022.Age-standardized incidence rate(ASIR)and mortality rates(ASMR)of cervical cancer were compared and linked to Human Development Index(HDI)between populations.The estimated annual percentage changes(EAPCs)were used to characterize the temporal trend in ASIR/ASMR,and demographic estimates were projected up to 2050.Results Globally,an estimated 662,044 cases(ASIR:14.12/100,000)and 348,709 deaths(ASMR:7.08/100,000)from cervical cancer occurred in 2022,corresponding to the fourth cause of cancer morbidity and mortality in women worldwide.Specifically,42%of cases and 39%of deaths occurred in China(23%and 16%)and India(19%and 23%).Both ASIR and ASMR of cervical cancer decreased with HDI,and similar decreasing links were observed for both early-onset(0–39 years)and late-onset(≥40 years)cervical cancer.Both ASIR and ASMR of overall cervical cancer showed decreasing trends during 2003–2012(EAPC:0.04%and-1.03%);however,upward trends were observed for early-onset cervical cancer(EAPC:1.16%and 0.57%).If national rates in 2022 remain stable,the estimated cases and deaths from cervical cancer are projected to increase by 56.8%and 80.7%up to 2050.Moreover,the projected increase of early-onset cervical cancer is mainly observed in transitioning countries,while decreased burden is expected in transitioned countries.Conclusions Cervical cancer remains a common cause of cancer death in many countries,especially in transitioning countries.Unless scaling-up preventive interventions,human papillomavirus(HPV)vaccination and cervical cancer screening,as well as systematic cooperation within government,civil societies,and private enterprises,the global burden of cervical cancer would be expected to increase in the future.
文摘This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in quality of life can significantly impact patients’lives.Currently,most treatments are supportive,with no specific treatment options available in Western medicine.Non-Western medicine,often less toxic and easier to administer,has shown promising results when used alongside radiotherapy for cervical cancer.Despite these potential benefits,challenges such as limited evidence and restricted application areas persist.While non-Western medicines may offer potential improvements in chemoradiotherapy outcomes for cervical cancer,further research is necessary to substantiate these benefits.
文摘BACKGROUND Cervical cancer is a formidable global health issue,particularly affecting women in lower-middle-income countries with little or no access to preventative vaccines,screening programs,and treatment modalities.The case report presents a unique case of a large cervical cancer achieving complete response(CR)with concurrent chemoradiotherapy(CCRT),highlighting the effectiveness of this treatment approach even in advanced stages and underscoring the importance of adaptive radiotherapy(RT)in optimizing patient outcomes.CASE SUMMARY We present the case of a 53-year-old woman who presented with four years of abnormal vaginal bleeding and was found to have p16-positive,moderately differentiated cervical squamous cell carcinoma.The tumor measured 14 cm×12 cm×8 cm,the largest size reported in the literature to achieve CR with CCRT.Despite this monumental feat,the patient remained disease-free and is currently on follow-up for 2 years;however,she continued to suffer from substantial morbidity caused by a vesicovaginal fistula and hydronephrosis,underscoring the continuing impact of cervical cancer on quality of life.CONCLUSION In this case report,we highlight the effectiveness of CCRT in achieving CR,even in cases of bulky cervical cancer,with adaptive RT offering a customized strategy to improve patient outcomes.We also emphasize the necessity for multidisciplinary team discussions and highlight the need for strategies to mitigate treatment-related toxicities and long-term complications.
基金supported by a grant from the National Key Research and Development Program of China(No.2022YFC2409901)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-011)。
文摘Objective:Cervical cancer is a growing concern in China,especially among women who reside in rural areas and older women.Understanding age-and region-specific trends in cervical cancer is vital for informing policy and assessing progress toward WHO elimination targets.Methods:The 2000±2020 data from 22 long-standing registries contributing to the China national cancer registry was analyzed to estimate age-standardized incidence and mortality rates(ASIR and ASMR,respectively).Joinpoint regression yielded an average annual percentage change(AAPC)stratified by age group(<35,35±64,65±74,and≥75 y)and by urban-rural area.The comparative analysis included GLOBOCAN Overtime data from selected Asia-Pacific countries.Results:The ASIR tripled in China between 2000 and 2020 before stabilizing(AAPC=6.5%),while the ASMR rose steadily(AAPC=3.9%).The urban incidence declined after 2009 among women<35 y,while rural trends were broadly stable.The ASIR and ASMR increased in urban areas among women 35±64 y of age,while rural areas had a rising ASIR and a stable ASMR,suggesting potential screening effects.In contrast,women≥65 y of age had a steadily increasing incidence and mortality in rural and urban areas.Australia and Republic of Korea had consistent declines in the ASIRs and ASMRs compared to other Asia-Pacific countries,whereas Japan exhibited rising trends.The Philippines experienced a surge in mortality rates,despite incidence rates remaining stable or declining.Conclusions:The cervical cancer burden in China has begun to plateau but large disparities persist by age and geography.To achieve elimination of cervical cancer,it is imperative to implement tailored strategies that prioritize the urgent expansion of HPV vaccination programs,the deployment of high-efficacy screening methods,and the universal access to treatment throughout the nation.
文摘To many people,especially women at the Mzuzu Central Hospital(MCH)in the Northern Region of Malawi,Du Shumin is a familiar and respected name.This is because of her expertise in cervical cancer treatment and the many women,some of whom never dreamed of living a normal life again,that Du has helped.
文摘In the article“LncRNA PCGEM1 facilitates cervical cancer progression via miR-642a-5p/KIF5B axis”(Oncology Research,2024,Vol 32,No.7,pp.1221-1229.doi:10.32604/or.2024.047454),there were some errors in the content.In order to ensure the scientific and rigorous nature of our academic publications,we deleted the incorrect content that is not related to this study,supplemented the details of the method.
文摘Introduction Progress toward the global elimination of cervical cancer as a public health concern remains slow and highly uneven across countries.High-income nations such as Australia and FinlandDboth of which have achieved high human papillomavirus(HPV)vaccination coverage and implemented quality-assured cervical cancer screening programs-have successfully decreased the incidence rates to below 8 cases per 100,000 women~1.These countries are on track to reach the elimination threshold of fewer than 4 cases per 100,000 women within the next few years,as defined by the World Health Organization(WHO).
基金Supported by National Natural Science Foundation of China,No.81602792The Natural Science Foundation of the Jiangsu Higher Education Institutions of China,No.23KJB310023+5 种基金Jiangsu Provincial Medical Key Discipline,No.ZDXK202235The Maternal and Child Health Research Project of Jiangsu Province,No.F202210The Project of State Key Laboratory of Radiation Medicine and Protection,Soochow University,No.GZK1202101Suzhou Science and Technology Development Plan Project,No.KJXW2020008BOXI Natural Science Cultivation Foundation of China of The First Affiliated Hospital of Soochow University,No.BXQN202107Clinical Diagnosis and Treatment Technology Innovation Project Youth Characteristic Technology Project of The First Affiliated Hospital of Soochow University,No.2100201.
文摘BACKGROUND Currently,there is limited research examining the relationship between anxiety,depression,coping styles,and illness uncertainty in patients with cervical cancer(CC)undergoing radiotherapy.Addressing this gap could provide valuable insights and more reliable evidence for clinical practice targeting this patient population.AIM To analyze the anxiety,depression,and coping styles of patients with CC undergoing radiotherapy and explore their correlations with illness uncertainty.METHODS A total of 200 patients with CC undergoing radiotherapy at The First Affiliated Hospital of Soochow University between June 2018 and June 2022 were enrolled.Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale(HADS),comprising subscales for anxiety(HADS-A)and depression(HADS-D).Coping styles were evaluated using the Jalowiec Coping Scale(JCS-60),comprising dimensions such as confrontive,evasive,optimistic,fatalistic,emotive,palliative,supportive,and self-reliant.Illness uncertainty was measured using the Mishel Uncertainty in Illness Scale(MUIS),encompassing ambiguity,complexity,information deficit,and unpredictability.Correlations among anxiety,depression,coping styles,and illness uncertainty were analyzed.RESULTS During radiotherapy,the mean scores were 7.12±3.39 for HADS-A,6.68±3.49 for HADS-D,1.52±0.23 for JCS-60,and 93.40±7.44 for MUIS.Anxiety(HADS-A≥8)was present in 39.5%of patients,depression(HADS-D≥8)in 41.0%,and both in 14.0%.Anxiety was significantly positively correlated with ambiguity,unpredictability,and total MUIS score(P<0.05).Depression was significantly positively correlated with ambiguity,information deficit,unpredictability,and total MUIS score(P<0.05).Most patients adopted an optimistic coping style,whereas the emotive style was least utilized.Evasive,fatalistic,and emotive coping styles were significantly positively correlated with illness uncertainty,whereas the self-reliant style was significantly negatively correlated with unpredictability(P<0.05).CONCLUSION Anxiety,depression,and coping styles in patients with CC undergoing radiotherapy correlate significantly with their level of illness uncertainty.Medical staff should address patients’psychological status and coping strategies by providing targeted information to reduce negative emotions,foster adaptive coping styles,and decrease illness uncertainty.
文摘Objective:To investigate the effects of arecoline on HPV-positive cervical cells and unveil its underlying mechanism in cervical carcinogenesis.Methods:The cytotoxicity of arecoline was determined and the effect of subtoxic concentrations of arecoline on the expression of viral oncoproteins and transcriptional factors was examined in CaSki and SiHa cells.HPV16 promoter activity was evaluated in a plasmid containing HPV16 long control region(pGL3-HPV16LCR)-transfected cells.Cell proliferation,cell migration,and number of colonies were assessed by MTT,wound healing assay,and colony-forming assay,respectively.Results:Arecoline at 0.01μg/mL significantly upregulated HPV16 E6 and E7 oncoproteins in both CaSki and SiHa cells.It also upregulated the expression level of c-Fos and c-Jun mRNAs,and c-Myc protein in CaSki and SiHa cells.In addition,arecoline at subtoxic concentrations(0.0025 and 0.01μg/mL)significantly induced HPV16 promoter activity in pGL3-16LCR-transfected cells.It also promoted SiHa and CaSki cell proliferation,migration,and colony formation.Conclusions:Arecoline at subtoxic concentrations promotes the proliferation,migration,and colony formation of CaSki and SiHa cells via upregulation of c-Fos,c-Jun,c-Myc,and HPV16 E6 and E7 expressions.
文摘BACKGROUND Cervical cancer is a prevalent form of cancer affecting women worldwide and it is the second most common cancer among women in Indonesia,accounting for 8.5%of all cancer-related deaths.Cervical cancer progression can be evaluated through laboratory tests to detect anaemia,an increased platelet count,and elevated inflammatory markers,therefore,effective laboratory examination is crucial for early detection and treatment of cervical cancer.AIM To evaluate the association between laboratory findings(haematology,haematology index,and inflammatory index)and the clinical stage of cervical cancer.METHODS This cross-sectional study analyzed adult cervical cancer patients’data from medical records and laboratory results including sociodemographic status,histopathological finding,clinical stage,and complete haematology examination.Numerical data was analyzed by the one-way ANOVA(normal data distribution),while the Kruskal-Wallis test was used for non-parametric data(abnormal distribution),followed by appropriate post-hoc analysis.The categorical data was analyzed by the Chi-square or Fisher Exact tests.The significance level was established at a P value<0.05.RESULTS This study involved the data of 208 adult cervical cancer patients and found no association between age,marital history,parity history,hormonal contraceptive use and cervical cancer stages.There were significant differences in the clinical laboratory test results based on the clinical stage of cervical cancer,including haemoglobin levels(P<0.001),leucocytes(P<0.001),neutrophils(P<0.001),monocytes(P=0.002),lymphocytes(P=0.006),platelets(P<0.001),neutrophil-lymphocyte ratio/NLR(P<0.001),lymphocyte-monocyte ratio/LMR(P<0.001),and plateletlymphocyte ratio/PLR(P<0.001).There were also significant differences in the systemic inflammatory index(SII)and systematic inflammatory response index(SIRI)between stage III+IV cervical cancer and stage II(SII P<0.001;SIRI P=0.001)and stage I(SII P<0.001;SIRI P=0.016),associated with the shifts in previously mentioned complete haematological values with cancer advancement.CONCLUSION The haematological parameters,inflammatory haematological ratios,and inflammatory indices exhibited significant differences between cervical cancer stages,therefore these tests can be utilized to evaluate cervical cancer progression.
基金Natural Science Key Research Project of Bengbu Medical University,No.2021byzd098.
文摘BACKGROUND Cervical cancer is a significant health concern among females in perimenopause,with a high prevalence of depression in this population.The rationale for this study was to explore the risk factors associated with depression in patients in perimenopause with cervical cancer.We hypothesized that socioeconomic status,disease characteristics,and quality of life factors contributed to the development of depression in these patients.AIM To investigate the risk factors associated with depression in patients in perimenopause with cervical cancer.METHODS A retrospective study was conducted on 254 patients in perimenopause with cervical cancer admitted to a single center.Patients were divided into a nondepression group(n=152)and a depression group(n=102)based on whether depression occurred after treatment.Data collection included demographic,clinical,and psychosocial factors.The Hamilton Depression Rating Scale was used to assess depression.Logistic regression analysis was performed to identify risk factors.RESULTS Patients with depression more often had low income(<4000 China yuan:66.7%vs 6.6%,P<0.001),initial disease onset(70.6%vs 57.2%,P=0.001),low social support(70.6%vs 55.3%,P=0.014),pathological stages III-IV(70.6%vs 41.5%,P<0.001),high pain level(65.7%vs 34.2%,P<0.001),and poor sleep quality(67.6%vs 32.2%,P<0.001).Logistic regression identified low income[odds ratio(OR)=32.606,P<0.001],initial disease onset(OR=4.282,P=0.001),pathological stages III-IV(OR=4.123,P=0.0005),high pain level(OR=1.181,P=0.0000434),and poor sleep quality(OR=3.094,P=0.0041)as key risk factors.CONCLUSION Low income,initial onset,low support,advanced stages,high pain,and poor sleep quality increased depression risk in patients in perimenopause with cervical cancer.Studies investigating interventions for this population are needed.
基金supported by CAMS Innovation Fund for Medical Sciences(CIFMS 2021-I2M-1-004)Tencent Sustainable Social Value Inclusive Health Lab and through the ChongQing Tencent Sustainable Development Foundation"Comprehensive Prevention and Control Demonstration Project for Eliminating Cervical Cancer and Breast Cancer in Low Health Resource Areas of China"(Project No.SD20240904145730)+1 种基金Tencent Sustainable Social Value Inclusive Health Lab(Project No.SSVPJ202307060001)Sanming Project of Medicine in Shenzhen(Project No.SZSM202211032)。
文摘Objective:Cervical cancer remains a global health challenge with substantial disparities between countries.High-quality colposcopy is essential for cervical cancer prevention,yet training opportunities remain inadequate worldwide.We developed the Intelligent Digital Education Tool for Colposcopy(iDECO)to address training gaps and evaluated the effect across diverse international settings.Methods:Six pre-post interventional training programmes were conducted in China,Mexico,and Mongolia from December 2024 to May 2025.A total of 369 trainees from 87 centers participated in a 3-week online training programme using iDECO,a bilingual webbased platform featuring authentic colposcopy cases,gamified learning pathways,and personalized analytics.The primary outcomes included colposcopy competence in general assessment,colposcopic findings,diagnostic accuracy,and management decisions.The secondary outcomes focused on participant feedback and satisfaction.Results:Of 369 participants who completed pretests,333(90.24%)completed post-training assessments.Significant improvements were observed across all competency domains.Diagnostic accuracy increased with an odds ratio(OR)of 1.72(95%CI:1.60±1.86)with the greatest gains in high-grade lesion identification[OR=2.27(95%CI:1.94±2.64)].Squamocolumnar junction visibility and transformation zone type assessments improved with ORs of 1.41(95%CI:1.31±1.51)and 1.87(95%CI:1.73±2.01),respectively.Biopsy decision-making accuracy also showed significant improvement[OR=2.09(95%CI:1.91±2.29)].International participants showed lower baseline performance but achieved the greatest improvements.Greater than 85%of participants rated the training highly satisfactory and 83.56%preferred intelligent training over traditional methods.Conclusions:iDECO-based training significantly improved colposcopy competence across diverse international settings with high user satisfaction.These findings support the potential for worldwide implementation of intelligent digital training tools to address colposcopy training gaps and contribute to the elimination of cervical cancer.
基金Supported by the Sichuan Science and Technology Program,No.2022NSFSC0797.
文摘BACKGROUND Cervical cancer is the most commonly diagnosed cancer worldwide and the most common cancer in females living with human immunodeficiency virus(HIV).Cervical cancer is classified as an acquired immune deficiency syndrome-defining disease.Brain metastases(BMs)from cervical cancer are extremely rare,with an incidence rate of approximately 0.63%,and there is limited information on optimal treatment protocols and patient outcomes.Since brain lesions are sequestered behind the blood-brain barrier,multimodal treatment approaches are crucial to help improve the prognosis of cervical cancer in patients with BMs who are also living with HIV.CASE SUMMARY A 42-year-old Chinese female with HIV infection was diagnosed with stage IIIC1r cervical cancer in March 2022 based on the International Federation of Gynecology and Obstetrics system.Fourteen months after undergoing the initial treatment with concurrent chemotherapy and radiotherapy in January 2024,the patient presented to a local hospital with a severe explosive headache.The patient underwent craniotomy and postoperative pathological examination confirmed metastasis of cervical squamous cell carcinoma to the brain on February 1,2024.Following surgery,the patient received external beam radiotherapy for the metastatic lesions.The patient has been under observation for 7 months with no evidence of tumor recurrence.CONCLUSION Females living with HIV are more than three times more likely to be diagnosed with cervical cancer.Due to the scarcity of cervical cancer BMs,therapeutic protocol experience is limited.In addition to the existence of the blood-brain barrier,the treatment of cervical cancer BMs appears to be exceptionally complex,and a multi-modal treatment approach consisting of chemotherapy,surgery,and radiation may help prolong patients’life.For females living with HIV,antiretroviral therapy should be prioritized,as recommended by the Center for Disease Control in China.An intact immune system and a high CD4+count are positive indicators of treatment response and tumor reduction.The overall survival of patients with cervical cancer after brain metastasis is approximately 3-5 months.However,owing to multimodal therapy and the use of antiretroviral therapy,the patient reported in this case showed no signs of recurrence after prolonged follow-up.
基金supported by the Chongqing Tencent Sustainable Development Foundation through the project"Comprehensive Prevention and Control Demonstration Project for Eliminating Cervical Cancer and Breast Cancer in Low Health Resource Areas of China"(Project No.SD20240904145730)by the Tencent Sustainable Social Value(SSV)Inclusive Health Lab(Project No.SSVPJ202307060001)。
文摘Objective:To describe temporal changes associated with deployment of an optical character recognition(OCR)-enabled OneIdentity(One-ID)digital platform for rural cervical cancer screening,focusing on over-screening rates,CIN2+detection,colposcopy follow-up,and CIN2+management.Methods:A multi-county pre-post observational study was conducted in six rural counties in Shanxi,Yunnan,and Sichuan Provinces(2021±2024),encompassing 153,978 encounters.The digital platform integrates OCR identity capture,deterministic One-ID linkage,and real-time duplicate alerts.Over-screening proportions before and after digital deployment were compared,changes in CIN2+detection rate were evaluated,and colposcopy follow-up and CIN2+management were assessed.Differences were tested withχ2 or Fisher's exact tests.Results:Among 153,978 encounters,the proportion of over-screening decreased from 12.64%in 2023 to 0.17%in 2024 with an absolute reduction of 12.17%(95%CI:11.94±12.40;P<0.001).The share of women receiving a first screening within the preceding 3 y increased from 78.3%to 88.2%(P<0.001).Colposcopy completion improved from 64.1%to 84.9%.The CIN2+detection rate rose from 0.35%(2021±2023 pooled)to 0.67%in 2024(P<0.001)and CIN2+management completion increased from 56.0%to 76.2%(95%CI:13.3±27.2;P<0.001).These improvements were consistent across age groups,counties,and screening strategies.Conclusions:The OCR-enabled One-ID platform substantially reduced over-screening,increased CIN2+detection rate,and strengthened case follow-up/management,particularly where baseline tracking was weak,supporting scalable digital reinforcement of rural screening programmes.
文摘Objective:Anillin(ANLN)is considered an oncogene in various cancers,but its effect on cervical cancer remains poorly understood.Hence,this study aimed to describe the action of ANLN on cervical cancer development and investigate the potential mechanism.Methods:Analysis of ANLN expression and its association with survival in carcinoma and endocervical adenocarcinoma(CESC)patients based on GEO and UALCAN databases.The tumor and adjacent normal tissues of 100 cervical cancer cases were harvested to detect the ANLN expression and explore its relationship with patient survival.Cell proliferation,apoptosis,migration,and invasion were measured by utilizing 5-ethynyl-2′-deoxyuridine(EdU)staining,Flow cytometry,and Transwell assay,respectively.ANLN andWnt expression were analyzed by RT-qPCR andWestern Blot.Results:ANLN was significantly elevated in tumor tissues,and cervical cancer cases with high ANLN expression exhibited poor survival and high dead proportion.Besides,ANLN induced cervical cancer cell proliferation,migration,and invasion and restrained cell apoptosis.In addition,ANLN promoted Wnt/β-catenin pathway activation.Furthermore,ANLN accelerated cell aggressive behaviors and suppressed cell apoptosis via activating the Wnt/β-catenin signaling in cervical cancer.Conclusion:ANLN was enhanced in cervical cancer tissues and related to poor prognosis.ANLN accelerated cervical cancer cell aggressive behaviors and suppressed cell apoptosis via activating theWnt/β-catenin pathway.
基金Supported by Natural Science Foundation of Hubei Province,No.2019CFC929。
文摘Cervical cancer remains a significant public health challenge,particularly in lowand middle-income countries.Screening of cervical cancer is crucial because it can detect precancerous changes and early-stage cancer.Regard to the screening methods,combination of human papillomavirus(HPV)testing and cytological examination has superior sensitivity and specificity compared to cytology alone.Thus,recent guidelines recommend this combined approach instead of cytology alone to reduced cervical cancer incidence and mortality.By using this combination,HPV testing identifies high-risk strains associated with cervical cancer,while cytology helps detect abnormal cellular changes.This dual strategy enhances early detection rates,allowing for timely intervention and treatment.Moreover,recent studies demonstrated that this screening strategy also significantly reduced detection costs,indicating the potential for this screening strategy to be promoted,especially in economically constrained regions.Despite challenges in screening,such as accessibility,public awareness,and cultural attitudes,educating communities on the importance of HPV testing and cytology can improve participation rates.Overall,a combined HPV testing and cytology screening strategy represents a proactive approach to cervical cancer prevention,promising to save lives through early detection and treatment.
基金supported by the Bill&Melinda Gates Foundation(Grant no.OPP1216421)CAMS Innovation Fund for Medical Sciences[CIFMS](Grant no.2021-I2M-1-004)。
文摘Objective:To evaluate the impact of government-organized screening on the economic burden among patients with cervical cancer and precancerous lesions,and explore mediating pathways across diagnosis,initial treatment,radiotherapy/chemotherapy,follow-up,and recurrence/progression/metastasis.Methods:A multicentre,nationwide survey across 5 disease courses was conducted from 26 hospitals in China.Multivariable regression and structural equation modeling were used to assess the effects of government-organized screening on economic burden by comparing government-organized screening with workplace check-up,self-paid check-up,and symptom-based detection.Results:Workplace check-up,self-paid check-up,and symptom-based detection were associated with progressively higher costs across diagnosis[β:1.10,95%confidence interval(CI):0.54±1.67;β:1.46,95%CI:1.00±1.92;andβ:1.68,95%CI:1.25±2.11,respectively],initial treatment(β:0.36,95%CI:0.18±0.55;β:0.51,95%CI:0.35±0.66;andβ:0.56,95%CI:0.42±0.70,respectively),and follow-up(β:0.63,95%CI:0.38±0.88;β:0.83,95%CI:0.61±1.04;andβ:0.85,95%CI:0.65±1.06,respectively)compared to government-organized screening(all P<0.05).Earlier clinical staging and greater use of lower-level hospitals mediated 44.74%±54.97%of cost differences in diagnosis,73.27%±85.04%in initial treatment,and 30.38%±54.73%in follow-up.Fifteen percent of the cost differences during initial treatment were related to lower overtreatment for precancerous lesions.Conclusions:Government-led cervical cancer screening was associated with lower economic burden with pathways involving earlier-stage diagnosis,reduced overtreatment,and decreased reliance on higher-level hospitals,suggesting potential clinical benefits,efficient resource use,and improved equity in cancer care.
文摘Background: Early research describing the concept of intensity-modulated conformal radiotherapy (IMRT) was based on 7 to 9 beams to reach an adequate level of modulation. Nevertheless, its implementation demands significant resources. Our objective was to compare the compliance and homogeneity of target dose distribution between simplified IMRT and 3D-CRT in patients with cervical cancer and to assess the clinical value of simplified IMRT. Materials and Methods: From 2016 to 2017, 17 patients with stage IIB - IIIC cervical cancer were treated with external beam radiotherapy using simplified IMRT (12 cases) or 3DCRT (05 cases) and brachytherapy. Prior to radiotherapy, CT scans were conducted to delineate the target volume. The clinical target volume (CTV) included the uterus, primary tumor, supravaginal portion of the cervix, paracervical tissue, common iliac, internal and external iliac lymph nodes, obturator, and pre sacral lymph nodes, and the surrounding tissues. If the lower vagina was involved, the target volume included the whole vagina. The planning target volume (PTV) included the CTV with 1 cm anteriorly and 0.5 cm in all other directions. The PTV received 95% of 45 Gy (1.8 Gy/25 fraction). Dose-volume histogram, conformity index, homogeneity index, and treatment time per fraction were compared. Results: The 3D-CRT plan was more homogeneous than the simplified IMRT plan, while the simplified IMRT plan was more conformal. The volume of small bowels that received high-dose radiation significantly increased with simplified IMRT compared to 3D-CRT. Treatment time per fraction was 6 and 13 minutes for 3D-CRT and simplified IMRT, respectively. Conclusion: The simplified IMRT treatment plan is technically and dosimetrically acceptable and an alternative to the classic 3D-CRT plan for cervical cancer. It provides better dose distribution than 3D-CRT. However, the 3D-CRT treatment plan significantly reduced the overall treatment time per fraction.
