Objective:We assessed the longitudinal risk of developing cervical intraepithelial neoplasia(CINs)with self-sampling human papillomavirus(HPV)tests,based on polymerase chain reaction(PCR)and signal amplification(care ...Objective:We assessed the longitudinal risk of developing cervical intraepithelial neoplasia(CINs)with self-sampling human papillomavirus(HPV)tests,based on polymerase chain reaction(PCR)and signal amplification(care HPV),to explore the appropriate intervals for cervical cancer screening.Methods:A prospective study was conducted in China during 2017-2020.Participants were invited for PCR and care HPV tests with self-samples at baseline.Women positive in either HPV test underwent colposcopy and biopsy if necessary.Women with baseline CIN grade one(CIN1)or less were followed up over 3 years.The absolute risk was assessed by the immediate risk(IR)and cumulative risk(CR),and the relative risk was assessed by the hazard ratio(HR)with a 95%confidence interval(CI).Results:A total of 8,126 women were included in the final analysis.Women positive for the PCR HPV test had comparable IRs of CIN2+and CIN3+to those positive on the care HPV test.With triage by HPV genotyping,women with HPV 16/18 infection had the highest IRs of CIN2+(21.15%)and CIN3+(9.67%).For CR,women negative for PCR HPV test had a lower risk of CIN2+than that reported in women negative on care HPV test(0.57%versus 0.98%,HR=0.58,95%CI:0.38,0.87),but no significant difference was found in the CRs of CIN3+between them(0.25%versus 0.39%,HR=0.64,95%CI:0.34,1.20).Among women with CIN1 or less at baseline,women who were persistent or recurrent positive on care HPV or PCR HPV test had a higher risk of developing CIN3+(11.36%-14.59%),compared with women remained HPV negative from baseline throughout follow-up(≤0.28%).Conclusions:Routine screening with 3-year intervals is acceptable for self-sampling HPV tests based on PCR or care HPV test.Women positive on HPV16/18 triaging at baseline or with CIN1 or less at baseline while being per-sistent or recurrent positive on care HPV or PCR HPV test during 3-year follow-up require immediate colposcopy or treatment.展开更多
Objective:Self-collection,self-testing,and telemedicine among high-risk populations were important strategies in increasing the accessibility of sexually transmitted infection(STI)services and facilitating their expan...Objective:Self-collection,self-testing,and telemedicine among high-risk populations were important strategies in increasing the accessibility of sexually transmitted infection(STI)services and facilitating their expansion.However,many previous studies have shown that the self-test kit usage and response rates are not high in the men who have sex with men(MSM)population.Different routes of recruitment may affect their response rates,however,limited evidence exists on how recruitment specifically influence STI self-testing participation among MSM populations.This study aims to analyze the differences in response rates of STI self-testing and submission rates of self-acquired samples from MSM recruited through an online platform,STI clinics,and non-governmental organizations(NGOs).Methods:Participants were enrolled via 3 different methods(STI clinics,“Aiyijian”online platform,and NGOs)from July to December 2022 in China.Self-testing kits for human immunodeficiency virus(HIV),Treponema pallidum,and hepatitis C virus,and self-sampling kits for Chlamydia trachomatis and Neisseria gonorrhea were provided to recruit MSM.The participant’s basic information was collected by using the questionnaire and the results of self-testing for HIV/syphilis and hepatitis C virus and self-sampling for Chlamydia trachomatis and Neisseria gonorrhoeae were collected.Multivariate logistic regression analysis was used to identify factors associated with self-test response rate and sample submission rates.Results:A total of 764 participants were recruited from 28 Chinese provinces.In the final analysis data,670 participants reported their HIV self-testing results,while 644 participants mailed their self-acquired samples to the laboratory.Among the 670 participants,there were 51 patients infected with HIV,31 infected with syphilis,and 2 infected with the hepatitis C virus.The total prevalences of Chlamydia trachomatis and Neisseria gonorrhea were 23.0%(176/637)and 7.6%(58/636),respectively.There was no significant difference among the willingness to self-test among participants recruited from 3 routines,while the HIV self-test response rate was significantly higher among participants recruited in STI clinics than among participants recruited through the“Aiyijian”platform(adjusted odds ratio[AOR]=0.018,95%confidence interval[CI]:0.002-0.136)or NGOs(AOR=0.054,95%CI:0.007-0.401).Compared to the participants recruited from STI clinics,the willingness of self-sample was significantly higher among participants recruited through the“Aiyijian”platform(AOR=4.557,95%CI:1.445-14.271)and NGO(AOR=2.391,95%CI:1.136-5.034),but the rectal sample submission rates were significantly lower among participants recruited by the“Aiyijian”platform(AOR=0.014,95%CI:0.003-0.062)or NGOs(AOR=0.062,95%CI:0.014-0.262).Conclusion:MSM recruited from the Aiyijian online platform and NGO were more willing to self-sample,while participants recruited from STI clinics had a greater test result response rate and self-sample submission rate than those recruited via the“Aiyijian”online platform and NGOs.In addition to STI clinics,online platforms and NGOs will play a very important role in recommending self-sampling for STIs among MSM population.展开更多
To accelerate our endeavors to overcome cancer,Chinese Journal of Cancer has launched a program of publishing 150most important questions in cancer research and clinical oncology.In this article,10 more questions are ...To accelerate our endeavors to overcome cancer,Chinese Journal of Cancer has launched a program of publishing 150most important questions in cancer research and clinical oncology.In this article,10 more questions are presented as follows.Question 15:Can tumor-induced erythrogenesis provide qualified red blood cells for carrying oxygen to distant organs?Question 16:Can we overcome tumor resistance to platinum-containing antineoplastic drugs by activating the sensitivity factors in the tumor?Question 17:How can a cancer cell stay dormant for years?Question 18:Why do cancer cells use distinct transcriptomic and proteomic programs to reach the same metastatic phenotype?Question 19:Why do some cancers regress spontaneously?Question 20:What are the regulatory mechanisms occurring in donor cells that determine selective sorting of biological content into vesicles and their biological consequences in recipient cells?Are the genetic transfer and exchange of biological messages between cells transient?Is the phenotypic manipulation of recipient cells temporary or prolonged and persistent?If extracellular vesicles possess immune-modulatory potential,how could they be exploited for immune interventions and cancer immunotherapy?Presumably the cargo of extracellular vesicles reflects the cells of their origin and can be used for cancer diagnosis,how could the uniform/stringent capture criteria be met universally for applying EVs in point-of-care diagnostics for cancer patients?Question 21:Can we use self-sampling technologies to monitor the tumor genetic alterations for more precise targeted therapy?Can we cure a heterogeneous tumor by sequentially targeting the driver molecules?Question 22:Can we postpone the onset of non-infection-related cancers?Question 23:How many types of cells can jointly form the tumor vasculature to provide blood supply for tumor progression?Question 24:How tumor cells transmit their epigenetic features to daughter cells and maintain the malignant phenotype?展开更多
Since 1998,Preventive Oncology International,Inc.(POI)has been at the forefront of studying human papillomavirus(HPV)self-collection for cervical cancer screening,with a significant focus in China.Through multiple cli...Since 1998,Preventive Oncology International,Inc.(POI)has been at the forefront of studying human papillomavirus(HPV)self-collection for cervical cancer screening,with a significant focus in China.Through multiple clinical trials over the past 25 years,POI has explored various aspects related to self-collection methodologies.In 2004–2006,POI established that self-collection could be equivalent to direct endocervical samples.Subsequently,a large randomized trial involving 10,000 patients in 2010 further confirmed that self-collected vaginal specimens,tested for high-risk HPV(hrHPV)using a PCR-based assay with high analytic sensitivity,could effectively replace endocervical specimens with minimal loss of sensitivity and a slight decrease in specificity.Throughout the years,POI's research has encompassed several crucial topics,including patient acceptance,the development of new cost-effective,simpler,and faster assays,exploring different collection devices,devising efficient methods of specimen transport,and implementing population-based screening systems.The findings strongly support the integration of self-collection methodologies into cervical cancer control programs worldwide,particularly in medically underserved regions.As HPV self-collection continues to evolve,ongoing research and innovations are expected to play a pivotal role in achieving the global mission of combating cervical cancer.展开更多
基金supported by the China Med-ical Board(grant number:16-255)the National Key R&D Program of China(grant number:2018YFC1315504)the National Natural Sci-ence Foundation of China(grant number:81761128006).
文摘Objective:We assessed the longitudinal risk of developing cervical intraepithelial neoplasia(CINs)with self-sampling human papillomavirus(HPV)tests,based on polymerase chain reaction(PCR)and signal amplification(care HPV),to explore the appropriate intervals for cervical cancer screening.Methods:A prospective study was conducted in China during 2017-2020.Participants were invited for PCR and care HPV tests with self-samples at baseline.Women positive in either HPV test underwent colposcopy and biopsy if necessary.Women with baseline CIN grade one(CIN1)or less were followed up over 3 years.The absolute risk was assessed by the immediate risk(IR)and cumulative risk(CR),and the relative risk was assessed by the hazard ratio(HR)with a 95%confidence interval(CI).Results:A total of 8,126 women were included in the final analysis.Women positive for the PCR HPV test had comparable IRs of CIN2+and CIN3+to those positive on the care HPV test.With triage by HPV genotyping,women with HPV 16/18 infection had the highest IRs of CIN2+(21.15%)and CIN3+(9.67%).For CR,women negative for PCR HPV test had a lower risk of CIN2+than that reported in women negative on care HPV test(0.57%versus 0.98%,HR=0.58,95%CI:0.38,0.87),but no significant difference was found in the CRs of CIN3+between them(0.25%versus 0.39%,HR=0.64,95%CI:0.34,1.20).Among women with CIN1 or less at baseline,women who were persistent or recurrent positive on care HPV or PCR HPV test had a higher risk of developing CIN3+(11.36%-14.59%),compared with women remained HPV negative from baseline throughout follow-up(≤0.28%).Conclusions:Routine screening with 3-year intervals is acceptable for self-sampling HPV tests based on PCR or care HPV test.Women positive on HPV16/18 triaging at baseline or with CIN1 or less at baseline while being per-sistent or recurrent positive on care HPV or PCR HPV test during 3-year follow-up require immediate colposcopy or treatment.
基金supported by the CAMS Innovation Fund for Medical Sciences(CIFMS,2021-I2M-C&T-B-086).
文摘Objective:Self-collection,self-testing,and telemedicine among high-risk populations were important strategies in increasing the accessibility of sexually transmitted infection(STI)services and facilitating their expansion.However,many previous studies have shown that the self-test kit usage and response rates are not high in the men who have sex with men(MSM)population.Different routes of recruitment may affect their response rates,however,limited evidence exists on how recruitment specifically influence STI self-testing participation among MSM populations.This study aims to analyze the differences in response rates of STI self-testing and submission rates of self-acquired samples from MSM recruited through an online platform,STI clinics,and non-governmental organizations(NGOs).Methods:Participants were enrolled via 3 different methods(STI clinics,“Aiyijian”online platform,and NGOs)from July to December 2022 in China.Self-testing kits for human immunodeficiency virus(HIV),Treponema pallidum,and hepatitis C virus,and self-sampling kits for Chlamydia trachomatis and Neisseria gonorrhea were provided to recruit MSM.The participant’s basic information was collected by using the questionnaire and the results of self-testing for HIV/syphilis and hepatitis C virus and self-sampling for Chlamydia trachomatis and Neisseria gonorrhoeae were collected.Multivariate logistic regression analysis was used to identify factors associated with self-test response rate and sample submission rates.Results:A total of 764 participants were recruited from 28 Chinese provinces.In the final analysis data,670 participants reported their HIV self-testing results,while 644 participants mailed their self-acquired samples to the laboratory.Among the 670 participants,there were 51 patients infected with HIV,31 infected with syphilis,and 2 infected with the hepatitis C virus.The total prevalences of Chlamydia trachomatis and Neisseria gonorrhea were 23.0%(176/637)and 7.6%(58/636),respectively.There was no significant difference among the willingness to self-test among participants recruited from 3 routines,while the HIV self-test response rate was significantly higher among participants recruited in STI clinics than among participants recruited through the“Aiyijian”platform(adjusted odds ratio[AOR]=0.018,95%confidence interval[CI]:0.002-0.136)or NGOs(AOR=0.054,95%CI:0.007-0.401).Compared to the participants recruited from STI clinics,the willingness of self-sample was significantly higher among participants recruited through the“Aiyijian”platform(AOR=4.557,95%CI:1.445-14.271)and NGO(AOR=2.391,95%CI:1.136-5.034),but the rectal sample submission rates were significantly lower among participants recruited by the“Aiyijian”platform(AOR=0.014,95%CI:0.003-0.062)or NGOs(AOR=0.062,95%CI:0.014-0.262).Conclusion:MSM recruited from the Aiyijian online platform and NGO were more willing to self-sample,while participants recruited from STI clinics had a greater test result response rate and self-sample submission rate than those recruited via the“Aiyijian”online platform and NGOs.In addition to STI clinics,online platforms and NGOs will play a very important role in recommending self-sampling for STIs among MSM population.
基金FAPESP(Sao Paulo Research Foundation, Proc.No.12/24574–3)CAPES(Coordination for the Improvement of Higher Education Personnel, Proc.No.BEX 7057/15-6)-Brazil
文摘To accelerate our endeavors to overcome cancer,Chinese Journal of Cancer has launched a program of publishing 150most important questions in cancer research and clinical oncology.In this article,10 more questions are presented as follows.Question 15:Can tumor-induced erythrogenesis provide qualified red blood cells for carrying oxygen to distant organs?Question 16:Can we overcome tumor resistance to platinum-containing antineoplastic drugs by activating the sensitivity factors in the tumor?Question 17:How can a cancer cell stay dormant for years?Question 18:Why do cancer cells use distinct transcriptomic and proteomic programs to reach the same metastatic phenotype?Question 19:Why do some cancers regress spontaneously?Question 20:What are the regulatory mechanisms occurring in donor cells that determine selective sorting of biological content into vesicles and their biological consequences in recipient cells?Are the genetic transfer and exchange of biological messages between cells transient?Is the phenotypic manipulation of recipient cells temporary or prolonged and persistent?If extracellular vesicles possess immune-modulatory potential,how could they be exploited for immune interventions and cancer immunotherapy?Presumably the cargo of extracellular vesicles reflects the cells of their origin and can be used for cancer diagnosis,how could the uniform/stringent capture criteria be met universally for applying EVs in point-of-care diagnostics for cancer patients?Question 21:Can we use self-sampling technologies to monitor the tumor genetic alterations for more precise targeted therapy?Can we cure a heterogeneous tumor by sequentially targeting the driver molecules?Question 22:Can we postpone the onset of non-infection-related cancers?Question 23:How many types of cells can jointly form the tumor vasculature to provide blood supply for tumor progression?Question 24:How tumor cells transmit their epigenetic features to daughter cells and maintain the malignant phenotype?
文摘Since 1998,Preventive Oncology International,Inc.(POI)has been at the forefront of studying human papillomavirus(HPV)self-collection for cervical cancer screening,with a significant focus in China.Through multiple clinical trials over the past 25 years,POI has explored various aspects related to self-collection methodologies.In 2004–2006,POI established that self-collection could be equivalent to direct endocervical samples.Subsequently,a large randomized trial involving 10,000 patients in 2010 further confirmed that self-collected vaginal specimens,tested for high-risk HPV(hrHPV)using a PCR-based assay with high analytic sensitivity,could effectively replace endocervical specimens with minimal loss of sensitivity and a slight decrease in specificity.Throughout the years,POI's research has encompassed several crucial topics,including patient acceptance,the development of new cost-effective,simpler,and faster assays,exploring different collection devices,devising efficient methods of specimen transport,and implementing population-based screening systems.The findings strongly support the integration of self-collection methodologies into cervical cancer control programs worldwide,particularly in medically underserved regions.As HPV self-collection continues to evolve,ongoing research and innovations are expected to play a pivotal role in achieving the global mission of combating cervical cancer.
