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Background: Young women's attendance at cervical screening in the UK is continuing to fall, and the incidence of invasive cervical cancer is rising. Objectives: We assessed the preferences of non‐attending young women for alternative ways of delivering cervical screening. Design: Postal discrete choice experiment (DCE) conducted during the STRATEGIC study of interventions for increasing cervical screening uptake. Attributes included action required to arrange a test, location of the test, availability of a nurse navigator and cost to the National Health Service. Setting and participants: Non‐attending young women in two UK regions. Main outcome measures: Responses were analysed using a mixed multinomial logit model. A predictive analysis identified the most preferable strategy compared to current screening. Preferences from the DCE were compared with observed behaviours during the STRATEGIC trial. Results: The DCE response rate was 5.5% (222/4000), and 94% of respondents agreed screening is important. Preference heterogeneity existed around attributes with strong evidence for test location. Relative to current screening, unsolicited self‐sampling kits for home use appeared most preferable. The STRATEGIC trial showed this same intervention to be most effective although many women who received it and were screened, attended for conventional cytology instead. Conclusions: The DCE and trial identified the unsolicited self‐sampling kit as the most preferred/effective intervention. The DCE suggested that the decision of some women receiving the kit in the trial to attend for conventional cytology may be due to anxieties around home testing coupled with a knowledge that ignoring the kit could potentially have life‐changing consequences. [ABSTRACT FROM AUTHOR]

Cervical cancer is the fourth most common malignancy diagnosed in women worldwide. Nearly all cases of cervical cancer result from infection with the human papillomavirus, and the prevention of cervical cancer includes screening and vaccination. Primary treatment options for patients with cervical cancer may include surgery or a concurrent chemoradiotherapy regimen consisting of cisplatin-based chemotherapy with external beam radiotherapy and brachytherapy. Cervical cancer causes more than one quarter of a million deaths per year as a result of grossly deficient treatments in many developing countries. This warrants a concerted global effort to counter the shocking loss of life and suffering that largely goes unreported. This article provides a review of the biology, prevention, and treatment of cervical cancer, and discusses the global cervical cancer crisis and efforts to improve the prevention and treatment of the disease in underdeveloped countries. Cancer 2017;123:2404-12. © 2017 American Cancer Society. [ABSTRACT FROM AUTHOR]

Background: Persistent infection with one or more high-risk human papillomavirus [HR-HPV] types increases the risk of intraepithelial neoplasia and cervical cancer. A nested case-control study was conducted to investigate the importance of cervical cell folate concentration and tumour suppressor gene methylation as risk factors for HR-HPV persistence. Methods: Cervical cell samples from 955 women with HR-HPV infection and normal, borderline or mild dyskaryosis were retrieved from the archive of a population-based screening trial. Women were classified as cases or controls, reflecting the presence or absence [respectively] of any HR-HPV infection at a follow-up clinic at least 6 months from baseline. Cervical cell folate concentration and promoter methylation of five tumour suppressor genes were measured in independent samples from cases and controls. Results: A higher cervical cell folate concentration [P = 0.015] was an independent predictor of infection at follow-up, together with infection with HPV-16 or infection with multiple HR-HPV types. Methylation of the tumour suppressor gene DAPK was associated with a 2.64-fold [95% CI, 1.35-5.17] increased likelihood of HPV infection whilst CDH1 methylation was associated with a 0.53-fold [95% CI, 0.331-0.844] likelihood of HR-HPV infection at follow-up. When considering women with normal or abnormal cytology, the predictive effect of higher cervical cell folate was only seen in women with mild cytology [P = 0.021]; similarly the effect of DAPK methylation was seen in women with mild or borderline cytology [P < 0.05]. Conclusions: Higher cervical cell folate concentration and promoter methylation of the tumour suppressor gene, DAPK, in women with cervical cell dyskaryosis, are associated with increased risk of HR-HPV persistence. [ABSTRACT FROM AUTHOR]

The discovery that human papillomavirus (HPV) is the necessary causal factor in cervical carcinogenesis has made it a target for prophylactic and therapeutic vaccines, as well as a diagnostic tool in cervical screening. Whilst prophylactic vaccination has proven very effective in terms of preventing cervical cancer precursor lesions, therapeutic strategies have presented far greater challenges. HPV testing has shown itself to be extremely valuable in the triage of low grade cytological abnormalities, test of cure following treatment of cervical intraepithelial neoplasia (CIN), and will, over the next 10 years, gradually replace cytology as the mainstay of primary cervical screening. In this review, the latest evidence supporting HPV as both a biomarker of risk for cervical cancer and a target for prophylactic and therapeutic vaccination is presented. [ABSTRACT FROM AUTHOR]

: ObjectivesTo investigate in vitro natural killer (NK) cell activity and expression of signal-transducing ζ chains in patients with cervical cancer.: Patients and methodsExperiments were performed with frozen lymphocytes from patients at all disease stages and from healthy controls. Thawed NK were activated by overnight incubation in interferon-γ (IFN-γ); activity against two target cell lines was assessed by 4-h 51Cr release assay. Targets chosen were K562, an erythroleukemic cell line, and a cervical carcinoma cell line designated 808. T and NK cell ζ chain expression was measured by flow cytometry.: ResultsPatients’ NK were found to be as cytotoxic as those of normal controls against cell lines K562 and 808. Patient T and NK cells did not show significant down-regulation of the ζ chain.: ConclusionsWe have found no evidence to suggest that loss of ζ chains is a mechanism for immunocompromise in patients with cervical carcinoma. IFN-recoverable patient NK activity is not reduced compared to matched controls. This may be clinically relevant since NK are active against cells exhibiting class I human leukocyte antigen (HLA) down-regulation and many cervical cancers show loss of HLA. [Copyright &y& Elsevier]

Summary: With the introduction of human papillomavirus (HPV) vaccination an evidence base on effective adolescent educational interventions is urgently required. We undertook formative research to develop and evaluate a film on HPV and cervical cancer prevention for school children who will be offered HPV vaccination in the UK. The main outcome measures were the number of children allowed by parents to view the film and children''s knowledge. Our results indicated that the film''s four key messages were acceptable to parents and largely understood by adolescents but these messages will need reinforcing if the full potential of a prophylactic vaccine is to be realised. [Copyright &y& Elsevier]

Cervical cancer is caused by human papillomavirus infection. Most human papillomavirus infection is harmless and dears spontaneously but persistent infection with high-risk human papillomavirus (especially type 16) can cause cancer of the cervix, vulva, vagina, anus, penis, and oropharynx. The virus exclusively infects epithelium and produces new viral particles only in fully mature epithelial cells. Human papillomavirus disrupts normal cell-cycle control, promoting uncontrolled cell division and the accumulation of genetic damage. Two effective prophylactic vaccines composed of human papillomavirus type 16 and 18, and human papillomavirus type 16,18, 6, and 11 virus-like particles have been introduced in many developed countries as a primary prevention strategy. Human papillomavirus testing is clinically valuable for secondary prevention in triaging low-grade cytology and as a test of cure after treatment. More sensitive than cytology, primary screening by human papillomavirus testing could enable screening intervals to be extended. If these prevention strategies can be implemented in developing countries, many thousands of lives could be saved. [ABSTRACT FROM AUTHOR]

The article presents the findings of a large study of the effectiveness of a human papillomavirus vaccine (HPV) in the prevention of cervical cancer in young wome. The survey's double bling, randomized control methodology is described. The survey found that the vaccine had a 90 percent success rate in preventing the development of cervical cancer in women who had certain varieties of the HP virus, and there was no significant difference in safety between them and the patients in the control group. The authors conclude the vaccine could be recommended for treatment, but caution that more time is needed to accurately measure its effectiveness in preventing the disease.