Clinico-pathological and epidemiological spectrum of ovarian cancer in Kashmir: a retrospective case control study

Objective: Ovarian cancer is the most dreadful gynecological malignancy among females worldwide, with worst prognosis and non-effectiveness of its screening markers yielding false negative cases. The aim of the present study was to investigate the clinicopathological and epidemiological profile of ovarian cancer patients in Kashmir ethnicity. Patients and Methods: The present observational cross-sectional study was conducted on 50 ovarian cancer patients who reported to the Department of General Surgery and Medical Oncology, SKIMS, Srinagar, from 2017 to 2019 and on 50 healthy female volunteers as age-matched controls. The clinicopathological and epidemiological profiles of the ovarian cancer patients were compared with those of normal controls. A detailed description of clinico-pathological, epidemiological, and etiological data was obtained from the in-patient record and questionnaire method and analyzed by Student's t-test to estimate statistically significant differences between cases and controls. The blood samples were assessed for CA-125 levels. p ≥ 0.05 differences were considered statistically significant. Results: Of the 50 ovarian cancer patients, the most affected (48%) age group was 44–59 years. The majority (64%) of the patients belonged to stages III and IV of the disease. Abdominal distension and pelvic pain were the most frequent symptoms observed in 46% and 44% of cases, respectively. Using Pearson’s correlation coefficient, we observed a significant negative correlation of risk of ovarian cancer with menarcheal age and a highly significant positive correlation with menopausal age, age at marriage, BMI, and CA125 in ovarian cancer patients. Conclusions: Most of the patients presented in an advanced stage of the disease and had CA125 levels of 500 U/ml. Awareness must be raised among women regarding the symptoms, warning signs, and risk factors of ovarian cancer because doing so will facilitate the early diagnosis of the disease

Prevalence of high-risk HPV genotypes, categorised by their quadrivalent and nine-valent HPV vaccination coverage, and the genotype association with high-grade lesions

BACKGROUND: The new nine-valent vaccine against human papillomavirus (HPV) includes the four HPV genotypes (6, 11, 16, and 18) that are targeted by the older quadrivalent HPV vaccine, plus five additional oncogenic types (31, 33, 45, 52, and 58) remain significantly associated with high grade lesions. We aimed to determine the prevalence of high-risk HPV genotypes in unvaccinated subjects and the association of these genotypes with the incidence of high-grade lesions. We also assessed which, if either, of these two HPV vaccines could have prevented these cases. METHODS: This cross-sectional study, conducted from 4 January 2010 to 30 December 2011, was composed of 595 women attending the Hospital General Universitario de Elche (Spain) gynaecology department who were positively screened for opportunistic cervical cancer by pap smears and HPV detection during a routine gynaecological health check. The pap smear results were classified using the Bethesda system. HPV genotyping was performed with the Linear Array HPV genotyping test, and viruses were classified by the International Agency for Research on Cancer assessment of HPV carcinogenicity. Odds ratios (ORs) with their 95% confidence intervals (95% CI) were estimated by logistic regression, adjusting for age and immigrant status. The prevented fraction among those exposed (PFe-adjusted) was determined as a measure of impact. RESULTS: At least one of the additional five high-risk HPV genotypes present in the nine-valent HPV vaccine was detected in 20.5% of subjects. After excluding women with genotype 16 and/or 18 co-infection, high-risk genotypes (31, 33, 45, 52, and 58) were associated with a higher risk of intraepithelial lesion or malignancy: adjusted OR?=?3.51 (95% CI, 1.29-9.56), PFe-adjusted?=?0.72 (95% CI, 0.22-0.90). Genotypes that are still non-vaccine-targeted were detected in 17.98% of the women, but these were not significantly associated with high-grade lesions. CONCLUSION: The greater protection of the nine-valent HPV vaccine is likely to have a positive impact because, in the absence of genotype 16 or 18 infection, these five genotypes on their own remained significantly associated with high-grade lesions