Human papillomavirus types in cervical high-grade lesions or cancer among Nordic women - Potential for prevention

Publisher's version (útgefin grein)It is valuable to establish a population‐based prevaccination baseline distribution of human papillomavirus (HPV) types among women with high‐grade cervical intraepithelial neoplasia (CIN) grade 2 or 3 and cervical cancer in order to assess the potential impact of HPV vaccination. In four countries (Denmark, Norway, Sweden, and Iceland), we collected consecutive series of cervical cancers (n = 639) and high‐grade precancerous cervical lesions (n = 1240) during 2004‐2006 before implementation of HPV vaccination and subjected the specimens to standardized HPV genotyping. The HPV prevalence was 82.7% (95% confidence interval [CI] 79.0‐86.4) in CIN2, 91.6% (95% CI 89.7‐93.5) in CIN3, and 86.4% (95% CI 83.7‐89.1) in cervical cancer. The most common HPV types in CIN2/3 were HPV16 (CIN2: 35.9%, 95% CI 31.2‐40.6; CIN3: 50.2%, 95% CI 46.8‐53.6) and HPV31 (CIN2: 10.9%, 95% CI 7.8‐13.9; CIN3: 12.1%, 95% CI 9.9‐14.3), while HPV16 and HPV18 were the most frequent types in cervical cancer (48.8%, 95% CI 44.9‐52.7 and 15.3%, 95% CI 12.5‐18.1, respectively). The prevalence of HPV16/18 decreased with increasing age at diagnosis in both CIN2/3 and cervical cancer (P < 0.0001). Elimination of HPV16/18 by vaccination is predicted to prevent 42% (95% CI 37.0‐46.7) of CIN2, 57% (95% CI 53.8‐60.5) of CIN3 and 64% (95% CI 60.3‐67.7) of cervical cancer. Prevention of the five additional HPV types HPV31/33/45/52/58 would increase the protection to 68% (95% CI 63.0‐72.2) in CIN2, 85% (95% CI 82.4‐87.2) in CIN3 and 80% (95% CI 77.0‐83.2) in cervical cancer. This study provides large‐scale and representative baselines for assessing and evaluating the population‐based preventive impact of HPV vaccination.We thank Cecilia Wahlström and Kia Sjölin for assistance with the HPV genotyping. SKK received lecture fee from Merck and Sanofi Pasteur MSD, scientific advisory board fee from Merck, and unrestricted research grants through her institution from Merck. JD reports having received research grants to his institution for the funding of the study. CM received lecture fees and travel grants from Sanofi Pasteur MSD. CL and MH report that their institution received a grant from Merck. KLL is a full‐time employee of Merck & Co. Inc and owns stocks and options of Merck. MN received research grants from MSD Norway/Merck through the affiliating institute. CDC, SG, LT, KS, and BTH report no conflicts of interest.Peer Reviewe

Atención al paciente oncológico en tiempos de COVID-19

Introduction: with the emergence of the new coronavirus and the wide worldwide distribution, its effects in people with some comorbidities are a global concern. Cancer is a disease with a high incidence and prevalence in society, included among the main causes of mortality.Objective: to describe the management of cancer patients during COVID-19Method: a literature review of articles published up to June 2020 was carried out, using the Pubmed / Medline, SCOPUS and SciELO databases. 28 references were selected for the preparation of the present.Development: cancer has variable clinical and prognostic behaviors that generally lead to states of immunosuppression caused by the therapeutics used for its treatment; Therefore, they are more vulnerable to infectious diseases. The proper care of this group of people is the responsibility of the health systems. Some measures are based on social distancing, either in reducing the number of companions of the patient in the consultation or chemotherapy sessions, the prohibition of visits to hospitalized patients and the use of technologies with the use of teleconsultations for routine follow-up, as well as the change from intravenous to oral treatmentsConclusions: the study of the behavior of COVID-19 in cancer patients is under development. The measures that the institutions take to achieve quality care for people with cancer are varied and are based mainly on social distancing.Introducción: con el surgimiento del nuevo coronavirus y la amplia distribución mundial, es una preocupación global sus efectos en personas con algunas comorbilidades. El cáncer es una enfermedad con alta incidencia y prevalencia en la sociedad, incluida entre las principales causas de mortalidad.Objetivo: describir el manejo del paciente oncológico durante la COVID-19Método: se realizó una revisión de la literatura de artículos publicados hasta junio del 2020, utilizando las bases de datos de Pubmed/Medline, SCOPUS y SciELO. Se seleccionaron 28 referencias para la elaboración de la presente.Desarrollo: el cáncer posee comportamientos clínicos y pronóstico variables que generalmente conllevan a estados de inmunosupresión causada por la terapéutica empleada para su tratamiento; por lo cual presentan mayor vulnerabilidad ante enfermedades infecciosas. Es responsabilidad de los sistemas de salud la correcta atención a este grupo de personas. Algunas medidas se basan en el distanciamiento social, ya sea en la reducción de la cantidad de acompañantes del paciente en la consulta o las sesiones de quimioterapia, la prohibición de las visitas a los pacientes hospitalizados y el empleo de las tecnologías con el uso de las teleconsultas para el seguimiento rutinario, así como el cambio de tratamientos por vía intravenosa a vía oralConclusiones: el estudio del comportamiento de la COVID-19 en pacientes oncológicos está en desarrollo. Las medidas que tomen las instituciones para lograr una atención de calidad a las personas que poseen cáncer son variadas y se basan sobre todo en el distanciamiento social

Cigarette use, comorbidities, and prognosis in a prospective head and neck squamous cell carcinoma population

BackgroundTo better understand the associations between a history of tobacco use and survival outcomes, cigarette use was prospectively surveyed in 687 previously untreated patients with cancer of the oral cavity (n = 271), oropharynx (n = 257), larynx (n = 135), or hypopharynx (n = 24).MethodsKaplan–Meier and Cox models explored the associations of tobacco use intensity (packs/day), duration (years of use), and timing before diagnosis with overall survival (OS), disease‐specific survival (DSS), and recurrence‐free survival (RFS).ResultsCigarette use duration, timing, and intensity were significant predictors for all outcomes in univariate analysis. Never smoking and pack‐years were not significantly associated with outcomes after adjustment for prognostic factors, such as stage, comorbidities, and human papillomavirus (HPV) status, which were strongly associated with clinical outcomes.ConclusionThe findings confirm the association between smoking history and survival and the importance of clinical variables in evaluating smoking as a prognostic factor. Timing, intensity, and duration of cigarette use should be considered with other prognostic factors when considering risk stratification for treatment planning. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1810–1820, 2016Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134806/1/hed24515.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134806/2/hed24515_am.pd

The aging clock: circadian rhythms and later life

Circadian rhythms play an influential role in nearly all aspects of physiology and behavior in the vast majority of species on Earth. The biological clockwork that regulates these rhythms is dynamic over the lifespan: rhythmic activities such as sleep/wake patterns change markedly as we age, and in many cases they become increasingly fragmented. Given that prolonged disruptions of normal rhythms are highly detrimental to health, deeper knowledge of how our biological clocks change with age may create valuable opportunities to improve health and longevity for an aging global population. In this Review, we synthesize key findings from the study of circadian rhythms in later life, identify patterns of change documented to date, and review potential physiological mechanisms that may underlie these changes

Lifetime and baseline alcohol intakes and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition study.

Recent evidence suggested a weak relationship between alcohol consumption and pancreatic cancer (PC) risk. In our study, the association between lifetime and baseline alcohol intakes and the risk of PC was evaluated, including the type of alcoholic beverages and potential interaction with smoking. Within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, 1,283 incident PC (57% women) were diagnosed from 476,106 cancer-free participants, followed up for 14 years. Amounts of lifetime and baseline alcohol were estimated through lifestyle and dietary questionnaires, respectively. Cox proportional hazard models with age as primary time variable were used to estimate PC hazard ratios (HR) and their 95% confidence interval (CI). Alcohol intake was positively associated with PC risk in men. Associations were mainly driven by extreme alcohol levels, with HRs comparing heavy drinkers (>60 g/day) to the reference category (0.1-4.9 g/day) equal to 1.77 (95% CI: 1.06, 2.95) and 1.63 (95% CI: 1.16, 2.29) for lifetime and baseline alcohol, respectively. Baseline alcohol intakes from beer (>40 g/day) and spirits/liquors (>10 g/day) showed HRs equal to 1.58 (95% CI: 1.07, 2.34) and 1.41 (95% CI: 1.03, 1.94), respectively, compared to the reference category (0.1-2.9 g/day). In women, HR estimates did not reach statistically significance. The alcohol and PC risk association was not modified by smoking status. Findings from a large prospective study suggest that baseline and lifetime alcohol intakes were positively associated with PC risk, with more apparent risk estimates for beer and spirits/liquors than wine intake

Do radial oxygen loss and external aeration affect iron plaque formation and arsenic accumulation and speciation in rice?

Hydroponic experiments were conducted to investigate the effect of radial oxygen loss (ROL) and external aeration on iron (Fe) plaque formation, and arsenic (As) accumulation and speciation in rice (Oryza sativa L.). The data showed that there were significant correlations between ROL and Fe concentrations in Fe plaque produced on different genotypes of rice. There were also significant differences in the amounts of Fe plaque formed between different genotypes in different positions of roots and under different aeration conditions (aerated, normal, and stagnant treatments). In aerated treatments, rice tended to have a higher Fe plaque formation than in a stagnant solution, with the greatest formation at the root tip decreasing with increasing distances away, in accordance with a trend of spatial ROL. Genotypes with higher rates of ROL induced higher degrees of Fe plaque formation. Plaques sequestered As on rice roots, with arsenate almost double that with arsenite, leading to decreased As accumulation in both roots and shoots. The major As species detected in roots and shoots was arsenite, ranging from 34 to 78% of the total As in the different treatments and genotypes. These results contribute to our understanding of genotypic differences in As uptake by rice and the mechanisms causing rice genotypes with higher ROL to show lower overall As accumulation

Night shift work and stomach cancer risk in the MCC-Spain study

OBJECTIVES: Night shift work has been classified as a probable human carcinogen by the International Agency for Research on Cancer, based on experimental studies and limited evidence on human breast cancer risk. Evidence at other cancer sites is scarce. We evaluated the association between night shift work and stomach cancer risk in a population-based case-control study. METHODS: A total of 374 incident stomach adenocarcinoma cases and 2481 population controls were included from the MCC-Spain study. Detailed data on lifetime night shift work were collected including permanent and rotating shifts, and their cumulative duration (years). Adjusted unconditional logistic regression models were used in analysis. RESULTS: A total of 25.7% of cases and 22.5% of controls reported ever being a night shift worker. There was a weak positive, non-significant association between ever having had worked for at least 1?year in permanent night shifts and stomach cancer risk compared to never having worked night shifts (OR=1.2, 95% CI 0.9 to 1.8). However, there was an inverse 'U' shaped relationship with cumulative duration of permanent night shifts, with the highest risk observed in the intermediate duration category (OR 10-20?years=2.0, 95% CI 1.1 to 3.6) (p for trend=0.19). There was no association with ever having had worked in rotating night shifts (OR=0.9, 95% CI 0.6 to 1.2) and no trend according to cumulative duration (p for trend=0.68). CONCLUSION: We found no clear evidence concerning an association between night shift work and stomach cancer ris