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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 19910

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Special Issue Editors

Prof. Dr. Kazunori Nagasaka

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Guest Editor

Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Tokyo 173-8605, Japan
Interests: gynecologic oncology; translational research; hysteroscopy
Special Issues, Collections and Topics in MDPI journals

Dr. Tetsuji Kurokawa

E-Mail Website
Assistant Editor

Department of Obstetrics and Gynecology, University of Fukui, Fukui, Japan
Interests: gynecologic oncology; human papillomavirus; cervical cancer screening

Special Issue Information

Dear Colleagues,

Cervical cancer incidence and mortality among young women have been increasing worldwide, with the vast majority occurring in low and middle-income countries. A recent strategy launched by the WHO projected a timeframe suggesting that cervical cancer could be globally eliminated in the world y 2120. However, there is still a certain discrepancy in the coverage of cervical cancer screening, HPV vaccination, and the management of the detected disease among several countries. Cervical cancer screening consists of cervical cytology test and human papillomavirus (HPV) testing. HPV screening sensitivity was uniformly higher than cytology for all ages, and therefore, recently, the use of HPV testing as the sole primary screening test has been well accepted worldwide. In addition, HPV vaccine coverage is inequitably distributed across geography and income. The new evidence should be updated to improve coverage. In this Special Issue, we aim to discuss cervical cancer prevention, which is essential to inform the precise planning of cervical cancer control and to overview the impact of control measures for cervical cancer prevention.

Dr. Kazunori Nagasaka
Dr. Tetsuji Kurokawa
Guest Editors

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Keywords

Cervical cancer screening
HPV testing
Cervical cytology
Cervical cancer prevention
HPV vaccination

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Published Papers (6 papers)

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Research

11 pages, 4130 KiB

Open AccessArticle

Awareness and Knowledge about Human Papilloma Virus Infection among Students at Secondary Occupational Health School in China

by Xin Wang, Taifeng Du, Xiaoling Shi and Kusheng Wu

Int. J. Environ. Res. Public Health 2021, 18(12), 6321; https://doi.org/10.3390/ijerph18126321 - 11 Jun 2021

Cited by 6 | Viewed by 2975

Abstract

Cervical cancer (CC) is one of the most common causes of cancer-related deaths worldwide. CC is mainly caused by human papilloma virus (HPV), which can be prevented by vaccination. We conducted a cross-sectional study in secondary occupational health school (SOHS) through a questionnaire aimed to assess the awareness and knowledge regarding HPV infection of students. A total of 2248 students participated in the survey, 45.3% of them had heard about CC, while only 21.9% of them had heard about HPV; and 74.2% had no idea of the causal link between HPV infection and CC. Most participants displayed poor awareness and knowledge about HPV infection. The results suggested that age, grade, major, academic performance, etc. were correlated with higher awareness of CC, HPV and HPV infection (p < 0.05). In multivariable logistic analysis, third-grade students had the most increased awareness of CC (OR = 17.13, 95%CI: [8.11, 36.15]), HPV (OR = 6.59, 95%CI: [4.16, 10.43]) and HPV vaccine (OR = 2.78, 95%CI: [1.78, 4.32]) when compared to first-grade. Awareness and knowledge regarding HPV infection were insufficient among students in SOHS. As the future healthcare providers, these results highlight the need to supplement targeted education to improve their awareness and knowledge of HPV and vaccination. Full article

(This article belongs to the Special Issue Cervical Cancer Prevention: Looking toward the Future)

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11 pages, 3397 KiB

Open AccessArticle

Impact of a Gender-Neutral HPV Vaccination Program in Men Who Have Sex with Men (MSM)

by Javier Díez-Domingo, Víctor Sánchez-Alonso, Rafael-J. Villanueva, Luis Acedo and José Tuells

Int. J. Environ. Res. Public Health 2021, 18(3), 963; https://doi.org/10.3390/ijerph18030963 - 22 Jan 2021

Cited by 8 | Viewed by 3102

Abstract

A major challenge in human papillomavirus (HPV) vaccine programs is the universal gender-neutral recommendation, as well as estimation of its long-term effect. The objective of this study is to predict the added benefit of male vaccination, especially in men who have sex with men (MSM), and to analyze the impact of the program on society. We propose a mathematical model of the HPV infection based on a network paradigm. Data from Spain allowed constructing the sexual network. HPV force of infection was taken from literature. Different scenarios using variable vaccine coverage in both males and females were studied. Strong herd immunity is shown in the heterosexual population, with an important decrease of HPV 6/11 infections both in men and in unvaccinated women with an only-women vaccination at 14 years of age. No impact of this program occurred in the infection incidence in MSM. This group would only benefit from a vaccination program that includes males. However, the impact at short term would be lower than in heterosexual men. The protection of MSM can only be achieved by direct vaccination of males. This may have important consequences for public health. Full article

(This article belongs to the Special Issue Cervical Cancer Prevention: Looking toward the Future)

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18 pages, 350 KiB

Open AccessFeature PaperArticle

Assessment of the State of Knowledge about HPV Infection and HPV Vaccination among Polish Resident Doctors

by Katarzyna Smolarczyk, Wojciech Pieta and Slawomir Majewski

Int. J. Environ. Res. Public Health 2021, 18(2), 551; https://doi.org/10.3390/ijerph18020551 - 11 Jan 2021

Cited by 14 | Viewed by 2913

Abstract

HPV (human papillomavirus) vaccinations have been introduced into the population of many countries through vaccination programs, although their acceptance varies from country to country, largely dependent on the state of knowledge about diseases caused by genital HPV types as well as cultural, social, and religious factors. The aim of the study was to analyze the state of knowledge about HPV and HPV vaccines among doctors during their specialization in gynecology and obstetrics, dermatology and venereology, and pediatrics. Another objective of the study was to analyze the impact of the state of knowledge about HPV vaccination on their attitude to primary prevention, i.e., vaccinations. A questionnaire was used to collect the data and 639 doctors took part in the study. The analysis was carried out mainly using descriptive statistical methods. In Poland, doctors’ knowledge about HPV is low, independent of gender, age, and subject of specialization. Doctors’ knowledge about the HPV vaccine is very low and independent of sex, age, and subject of specialization. However, doctors’ knowledge about HPV and the HPV vaccine influences the attitude to HPV vaccination and does not affect pro-active behaviors. Full article

(This article belongs to the Special Issue Cervical Cancer Prevention: Looking toward the Future)

16 pages, 857 KiB

Open AccessArticle

Cervical Cancer Screening Participation among Women of Russian, Somali, and Kurdish Origin Compared with the General Finnish Population: A Register-Based Study

by Esther E. Idehen, Anni Virtanen, Eero Lilja, Tomi-Pekka Tuomainen, Tellervo Korhonen and Päivikki Koponen

Int. J. Environ. Res. Public Health 2020, 17(21), 7899; https://doi.org/10.3390/ijerph17217899 - 28 Oct 2020

Cited by 6 | Viewed by 3519

Abstract

Migrant-origin women are less prone to cervical screening uptake compared with host populations. This study examined cervical cancer screening participation and factors associated with it in the Finnish mass screening program during 2008–2012 in women of Russian, Somali and Kurdish origin compared with the general Finnish population (Finns) in Finland. The study population consists of samples from the Finnish Migrant Health and Well-being Study 2010–2012 and Health 2011 Survey; aged 30–64 (n = 2579). Data from the Finnish screening register linked with other population-based registry data were utilized. For statistical analysis we employed logistic regression. Age-adjusted screening participation rates were Russians 63% (95% CI: 59.9–66.6), Somalis 19% (16.4–21.6), Kurds 69% (66.6–71.1), and Finns 67% (63.3–69.8). In the multiple-adjusted model with Finns as the reference; odds ratios for screening were among Russians 0.92 (0.74–1.16), Somalis 0.16 (0.11–0.22), and Kurds 1.37 (1.02–1.83). Among all women, the substantial factor for increased screening likelihood was hospital care related to pregnancy/birth 1.73 (1.27–2.35), gynecological 2.47 (1.65–3.68), or other reasons 1.53 (1.12–2.08). Screening participation was lower among students and retirees. In conclusion, screening among the migrant-origin women varies, being significantly lowest among Somalis compared with Finns. Efforts using culturally tailored/population-specific approaches may be beneficial in increasing screening participation among women of migrant-origin. Full article

(This article belongs to the Special Issue Cervical Cancer Prevention: Looking toward the Future)

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9 pages, 715 KiB

Open AccessArticle

Recent Increasing Incidence of Early-Stage Cervical Cancers of the Squamous Cell Carcinoma Subtype among Young Women

by Takafumi Noguchi, Masayoshi Zaitsu, Izumi Oki, Yasuo Haruyama, Keiko Nishida, Koji Uchiyama, Toshimi Sairenchi and Gen Kobashi

Int. J. Environ. Res. Public Health 2020, 17(20), 7401; https://doi.org/10.3390/ijerph17207401 - 12 Oct 2020

Cited by 16 | Viewed by 2858

Abstract

Few studies have reported on the increase in cervical cancer incidence in Japan. We aimed to determine the relevant trends in the metropolitan regions of Japan and to identify the population with the highest risk, based on histological subtype, cancer stage, and diagnostic processes. Using population-based data (2009–2013), we identified 2110 women, aged ≥20 years, with cervical cancer. We estimated the age-standardized and age-specific incidence rates of cervical cancer for the study period based on the 1985 national model population. The average annual percent change (AAPC) and 95% confidence interval (CI) were calculated using the joinpoint regression analysis. We stratified the analyses based on histological subtypes, stage, and diagnostic process via cancer screening. The increase in the overall age-standardized incidence was not significant. However, the increase was significant for women aged 30–39 years (AAPC 20.0%/year, 95% CI: 9.9–31.1), which was attributable to the increase in the incidence of the squamous cell carcinoma (SCC) subtype (AAPC 23.1%/year, 95% CI: 10.7–36.8). Among younger women, aged <50 years, further stratification showed an increase in the undiagnosed early-stage SCC subtype via cancer screening. In Japan, the incidence of HPV-related cervical cancer has been increasing in undiagnosed younger women. Full article

(This article belongs to the Special Issue Cervical Cancer Prevention: Looking toward the Future)

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14 pages, 1396 KiB

Open AccessArticle

The Burden of Cervical Cancer in Korea: A Population-Based Study

by Jinhee Kim, Donghwan Lee, Kyung-Bok Son and SeungJin Bae

Int. J. Environ. Res. Public Health 2020, 17(17), 6308; https://doi.org/10.3390/ijerph17176308 - 30 Aug 2020

Cited by 5 | Viewed by 3577

Abstract

This study used the Korean National Health Insurance (NHI) claims database from 2011 to 2017 to estimate the incidence and the incidence-based cost of cervical cancer and carcinoma in situ of cervix uteri (CIS) in Korea. The primary outcome was the direct medical cost per patient not diagnosed with cervical cancer (C53) or CIS (D06) 2 years prior to the index date in the first year after diagnosis. A regression analysis was conducted to adjust for relevant covariates. The incidence of cervical cancer tended to decrease from 2013 to 2016, while that of CIS increased. In particular, the incidence rate of CIS in women in their 20 s and 30 s increased by 56.8% and 28.4%, respectively, from 2013 to 2016. The incidence-based cost of cervical cancer and CIS was USD 13,058 and USD 2695 in 2016, respectively, which increased from 2013. Multivariate regression analysis suggested that age was the most influential variable of the cost in both patient groups, and the cost was highest in those aged over 60, i.e., the medical cost was significantly lower in younger women than their older counterparts. These findings suggest that targeting younger women in cervical cancer prevention is a reasonable option from both economic and public health perspectives. Full article

(This article belongs to the Special Issue Cervical Cancer Prevention: Looking toward the Future)

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