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Genetic susceptibility to cervical cancer: role of common polymorphisms in apoptosis-related genes

Tan SC, Ankathil R

Tumour Biol., 2015 Sep;36(9):6633-44.
PMID: 26242271 DOI: 10.1007/s13277-015-3868-2

Cervical cancer is a common malignancy which poses a significant health burden among women, especially those living in the developing countries. Although human papillomavirus (HPV) infection has been unequivocally implicated in the etiopathogenesis of the cancer, it alone is not adequate to contribute to the malignant transformation of cervical cells. Most HPV infections regress spontaneously, and only a small proportion of women have persistent infections which eventually lead to malignancy. This suggests that interplays between HPV infection and other cofactors certainly exist during the process of cervical carcinogenesis, which synergistically contribute to the differential susceptibility of an individual to the malignancy. Undoubtedly, host genetic factors represent a major element involved in such a synergistic interaction, and accumulating evidence suggests that polymorphisms in apoptosis-related genes play an important role in the genetic susceptibility to cervical cancer. This review consolidates the recent literatures on the role of common polymorphisms in apoptosis-related genes in genetic susceptibility to cervical cancer.

Matched MeSH terms: Papillomaviridae/pathogenicity
Cervical cancer burden, status of implementation and challenges of cervical cancer screening in Association of Southeast Asian Nations (ASEAN) countries

Zhao S, Huang L, Basu P, Domingo EJ, Supakarapongkul W, Ling WY, et al.

Cancer Lett, 2022 Jan 28;525:22-32.
PMID: 34728309 DOI: 10.1016/j.canlet.2021.10.036

Multiple barriers impede the transformation of evidence-based research into implementation of cervical cancer screening in ASEAN countries. This review is the first of its kind to show the disease burden of cervical cancer, progress till date to implement screening and corresponding challenges, and propose tailored solutions to promote cervical cancer prevention in ASEAN. In 2020, approximately 69 000 cervical cancer cases and 38 000 deaths happened in ASEAN, and more than 44% and 63% increases on new cases and deaths are expected in 2040. Only four countries have initiated population-based cervical cancer screening programs, but the participation rate is less than 50% in some countries and even lower than 10% in Myanmar and Indonesia. Inequity and unavailability in service delivery, lack of knowledge and awareness, limited follow-up and treatment capacity, and funding sustainability affect successful scale-up of cervical cancer screening most in ASEAN. Implementing HPV detection-based primary screening, appropriate management of screen-positives, enhancing health education, integrating health services can accelerate reduction of cervical cancer burden in ASEAN. Achieving high screening coverage and high treatment compliance will help ASEAN countries remain aligned to cervical cancer elimination strategies.

Matched MeSH terms: Papillomaviridae/pathogenicity
Practice of HPV vaccine and associated factors among school girls in Melaka, Malaysia

Al-Naggar RA, Bobryshev YV, Al-Jashamy K, Al-Musli M

Asian Pac J Cancer Prev, 2012;13(8):3835-40.
PMID: 23098480

OBJECTIVE: The objective of this study is to determine the practice and associated factors of HPV vaccine among school girls in Melaka, Malaysia.
METHODOLOGY: A total number of 612 secondary school girls participated in this study. The questionnaire consists of 38 questions which included 3 sections. The first section is about socio- demography. The Second section is about knowledge and awareness of HPV vaccines. The third section is about practices with associated barriers of HPV vaccination. Verbal consent was obtained from all participants, and data were analyzed using SPSS 13.
RESULTS: A total number of 612 secondary school girl students participated in this study. The mean age was 13.93 ± SD (1.09); minimum age was 13 years old and maximum was 17 years old. The majority of them was Malay, from rural areas and had a family monthly income of RM 3000 or less (91.8%, 53.1%, 69.6%; respectively). The majority of the parents of the school girls were with secondary education level (56.4%). The majority of the participants did not have a family history of cervical cancer (99.0%). The prevalence of HPV vaccination was 77.9% among school girls in Melaka. The majority of the participants were vaccinated in their schools (77.0%). About 69% knew about cervical cancer and 77.6% had ever heard about HPV vaccine. Regarding the factors that influence the practice of uptake HPV vaccine, they were age, race, income, parents' education, knowledge about cervical cancer, heard about HPV vaccine and place of getting the vaccine (p<0.001).
CONCLUSION: The prevalence of HPV vaccine among school girls is high. Age, race, income, parents' education, knowledge about cervical cancer, heard about HPV vaccine and place of getting the vaccine were the significant factors that influence the practice of uptake HPV vaccine among school girls.

Matched MeSH terms: Papillomaviridae/pathogenicity*
Knowledge, attitude and practice of malaysian medical and pharmacy students towards human papillomavirus vaccination

Rashwan HH, Saat NZ, Abd Manan DN

Asian Pac J Cancer Prev, 2012;13(5):2279-83.
PMID: 22901207

Human Papillomavirus (HPV) infection is one of the most common sexually transmitted infections and oncogenic HPV is the main cause of cervical cancer. However, HPV vaccination is already available as the primary preventive method against cervical cancer. The objective of this study was to determine the level of knowledge, attitude and practice of HPV vaccination among Universiti Kebangsaan Malaysia (UKM) and Universiti Malaya (UM) students. This study was conducted from March until August 2009. Pre-tested and validated questionnaires were filled by the third year UKM (n=156) and UM (n=149) students from medical, dentistry and pharmacy faculties. The results showed that the overall level of knowledge on HPV infection, cervical cancer and its prevention among respondents was high and the majority of them had positive attitude towards HPV vaccination. Medical students had the highest level of knowledge (p<0.05). Very few students (3.6%) had already taken the vaccine with no significant difference between the two Universities (p=0.399). In conclusion, the knowledge and attitude of the respondents were high and positive, respectively. Only few students took HPV vaccination. Thus, more awareness campaigns and HPV vaccination services should be provided at universities' campuses with the price of the HPV vaccine reduced for the students.

Matched MeSH terms: Papillomaviridae/pathogenicity
Knowledge of Human Papillomavirus Infection, Cervical Cancer and Willingness to pay for Cervical Cancer Vaccination among Ethnically Diverse Medical Students in Malaysia

Maharajan MK, Rajiah K, Num KS, Yong NJ

Asian Pac J Cancer Prev, 2015;16(14):5733-9.
PMID: 26320444

The primary objective of this study was to assess the knowledge of medical students and determine variation between different cultural groups. A secondary aim was to find out the willingness to pay for cervical cancer vaccination and the relationships between knowledge and attitudes towards Human Papillomavirus vaccination. A cross-sectional survey was conducted in a private medical university between June 2014 and November 2014 using a convenient sampling method. A total of 305 respondents were recruited and interviewed with standard questionnaires for assessment of knowledge, attitudes and practice towards human papilloma virus and their willingness to pay for HPV vaccination. Knowledge regarding human papilloma virus, human papilloma virus vaccination, cervical cancer screening and cervical cancer risk factors was good. Across the sample, a majority (90%) of the pupils demonstrated a high degree of knowledge about cervical cancer and its vaccination. There were no significant differences between ethnicity and the participants' overall knowledge of HPV infection, Pap smear and cervical cancer vaccination. Some 88% of participants answered that HPV vaccine can prevent cervical cancer, while 81.5% of medical students said they would recommend HPV vaccination to the public although fewer expressed an intention to receive vaccination for themselves.

Matched MeSH terms: Papillomaviridae/pathogenicity
Journey of the Human Papillomavirus (HPV) in a Developing Country over 5 Years (2010 - 2015)

Danial M, Sivasangari S, Arulappen A, Ong L

Asian Pac J Cancer Prev, 2016;17(3):1363-8.
PMID: 27039773

Human papillomavirus (HPV) is a prevalent sexually transmitted infection with serious medical, sexual, and relationship consequences. HPV vaccine protection is available globally but unfortunately vaccine uptake is inconsistent everywhere. From this study, it was observed that the awareness of cervical cancer, HPV virus and HPV vaccination in Malaysia is high, at 83.1%, 73.9% and 73.3% of respondents, respectively. However, a considerably low percentage had undergone HPV vaccination (8.6%) compared to those who had experienced a Pap smear (32.9%). Awareness between cervical cancer and HPV virus and vaccination was low. Health care providers and the governing bodies have to play a vital role in disseminating holistic information on the vaccine and the importance of getting vaccinated to the public more vigorously in Malaysia.

Matched MeSH terms: Papillomaviridae/pathogenicity*
High Prevalence of Human Papillomavirus Types 56 and 70 Identified in the Native Populations of Sabah, Malaysia

Sainei NE, Kumar VS, Chin YS, Salih FAM

Asian Pac J Cancer Prev, 2018 Oct 26;19(10):2807-2813.
PMID: 30360610

Background: Cervical cancer is currently the third most common female cancer in Malaysia , with the human
papillomavirus (HPV) considered as one of the important contributory factors. This study was conducted to determine
HPV prevalence, its genotype distribution, and other potential risk factors among women in Kota Kinabalu, Sabah
in order to evaluate the likely efficacy of current HPV vaccines in the local population. Methods: A total of 240
cervical samples were collected and subjected to DNA extraction, PCR amplification using the MY09/MY11 primer
pair, and restriction fragment length polymorphism (RFLP) for HPV detection and genotyping. Sociodemographic,
clinical, and behavioural data were also collected via questionnaires. Results: The prevalence of HPV infection was
9.6%. The most common HPVs among 13 genotypes were high-risk HPV-56 (16.7%) and probable high-risk HPV-70
(16.7%) followed by HPV-16, -58, -53, -61, -33, -59, and -66 (in decreasing order of prevalence) including the rare
genotypes: HPV-62, -81, -82 and -84. Statistical analyses using logistic regression models showed that HPV infection
was significantly associated with employment (OR 4.94; CI 1.58-15.40) and education at secondary/high school level
(OR 0.13; CI 0.03-0.62). Conclusion: Distribution of HPV genotypes in Sabah indicated a high prevalence of HPV-56
and -70 which are among the rare HPV types in West Malaysia and merit consideration in future strategies for HPV
vaccination specifically for local Sabahan women.

Matched MeSH terms: Papillomaviridae/pathogenicity*