317 results on '"Patrick Petignat"'
Search Results
52. Impact of an educational intervention on women's knowledge and acceptability of human papillomavirus self-sampling: a randomized controlled trial in Cameroon.
- Author
-
Gaëtan Sossauer, Michel Zbinden, Pierre-Marie Tebeu, Gisèle K Fosso, Sarah Untiet, Pierre Vassilakos, and Patrick Petignat
- Subjects
Medicine ,Science - Abstract
OBJECTIVE: Human papillomavirus (HPV) self-sampling (Self-HPV) may be used as a primary cervical cancer screening method in a low resource setting. Our aim was to evaluate whether an educational intervention would improve women's knowledge and confidence in the Self-HPV method. METHOD: Women aged between 25 and 65 years old, eligible for cervical cancer screening, were randomly chosen to receive standard information (control group) or standard information followed by educational intervention (interventional group). Standard information included explanations about what the test detects (HPV), the link between HPV and cervical cancer and how to perform HPV self-sampling. The educational intervention consisted of a culturally tailored video about HPV, cervical cancer, Self-HPV and its relevancy as a screening test. All participants completed a questionnaire that assessed sociodemographic data, women's knowledge about cervical cancer and acceptability of Self-HPV. RESULTS: A total of 302 women were enrolled in 4 health care centers in Yaoundé and the surrounding countryside. 301 women (149 in the "control group" and 152 in the "intervention group") completed the full process and were included into the analysis. Participants who received the educational intervention had a significantly higher knowledge about HPV and cervical cancer than the control group (p
- Published
- 2014
- Full Text
- View/download PDF
53. How to improve cervical cancer screening in Switzerland?
- Author
-
Patrick Petignat, Sarah Untiet, and Pierre Vassilakos
- Subjects
cervical cancer screening ,HPV testing ,human papillomavirus ,Switzerland ,Medicine - Published
- 2012
- Full Text
- View/download PDF
54. Self-supervised learning-based cervical cytology for the triage of HPV-positive women in resource-limited settings and low-data regime.
- Author
-
Thomas Stegmüller, Christian Abbet, Behzad Bozorgtabar, Holly Clarke, Patrick Petignat, Pierre Vassilakos, and Jean-Philippe Thiran
- Published
- 2024
- Full Text
- View/download PDF
55. Self-Supervised Learning-Based Cervical Cytology Diagnostics in Low-Data Regime and Low-Resource Setting.
- Author
-
Thomas Stegmüller, Christian Abbet, Behzad Bozorgtabar, Holly Clarke, Patrick Petignat, Pierre Vassilakos, and Jean-Philippe Thiran
- Published
- 2023
- Full Text
- View/download PDF
56. Telecytologic diagnosis of cervical smears for triage of self-sampled human papillomavirus–positive women in a resource-limited setting: concept development before implementation
- Author
-
Pierre Vassilakos, Holly Clarke, Micol Murtas, Thomas Stegmüller, Ania Wisniak, Farida Akhoundova, Zacharie Sando, George Enow Orock, Jessica Sormani, Jean-Philippe Thiran, and Patrick Petignat
- Subjects
Pathology and Forensic Medicine - Published
- 2023
57. Exploring the potential impact of human papillomavirus on infertility and assisted reproductive technology outcomes
- Author
-
Luca Tramontano, Romualdo Sciorio, Serena Bellaminutti, Sandro C. Esteves, and Patrick Petignat
- Subjects
Human papillomavirus (HPV) infection ,Endocrinology ,Human fertility ,in-vitro fertilization (IVF) ,Assisted reproductive technology (ART) ,Semen sample ,Animal Science and Zoology ,Developmental Biology - Abstract
Human papillomavirus (HPV) is a common sexually transmitted disease that has been linked to both cancer and reproductive health issues. While its impact on fertility and pregnancy success has been studied, there is still too little evidence about the influence of HPV on assisted reproductive technology (ART). Therefore, there exists a need for HPV testing in couples undergoing infertility treatments. Infertile men have been found to have a higher prevalence of seminal HPV infection, which can compromise sperm quality and reproductive function. As such, it could be important to investigate the correlation between HPV and ART outcomes in order to improve the quality of evidence. Understanding the potentially detrimental effects of HPV on ART outcomes may have promising important implications for the management of infertility. This minireview summarizes the so far limited developments in this area and highlights the major need for further well-designed studies to address this issue.
- Published
- 2023
58. Data from Location of Mutation in BRCA2 Gene and Survival in Patients with Ovarian Cancer
- Author
-
Isabelle Ray-Coquard, Valérie Bonadona, Lisa Golmard, Adrien Buisson, Dominique Stoppa-Lyonnet, Claude Houdayer, Marc-Henri Stern, Pierre O. Chappuis, Aurélie Ayme, Valeria Viassolo, Patrick Meraldi, Pierre Meeus, Sarah Stuckelberger, Pierre-Etienne Heudel, Olivier Tredan, Nicolas Chopin, Beata Rak, Patrick Petignat, Alexandre Bodmer, Olfa Derbel, Domenico Ferraioli, Manuel Rodrigues, Timothée Olivier, and S. Intidhar Labidi-Galy
- Abstract
Purpose: BRCA2 plays a central role in homologous recombination by loading RAD51 on DNA breaks. The objective of this study is to determine whether the location of mutations in the RAD51-binding domain (RAD51-BD; exon 11) of BRCA2 gene affects the clinical outcome of ovarian cancer patients.Experimental Design: A study cohort of 353 women with ovarian cancer who underwent genetic germline testing for BRCA1 and BRCA2 genes was identified. Progression-free survival (PFS), platinum-free interval (PFI), and overall survival (OS) were analyzed. The Cancer Genome Atlas (TCGA) cohort of ovarian cancer (n = 316) was used as a validation cohort.Results: In the study cohort, 78 patients were carriers of germline mutations of BRCA2. After adjustment for FIGO stage and macroscopic residual disease, BRCA2 carriers with truncating mutations in the RAD51-BD have significantly prolonged 5-year PFS [58%; adjusted HR, 0.36; 95% confidence interval (CI), 0.20–0.64; P = 0.001] and prolonged PFI (29.7 vs. 15.5 months, P = 0.011), compared with noncarriers. BRCA2 carriers with mutations located in other domains of the gene do not have prolonged 5-year PFS (28%, adjusted HR, 0.67; 95% CI, 0.42–1.07; P = 0.094) or PFI (19 vs. 15.5 months, P = 0.146). In the TCGA cohort, only BRCA2 carriers harboring germline or somatic mutations in the RAD51-BD have prolonged 5-year PFS (46%; adjusted HR, 0.30; 95% CI, 0.13–0.68; P = 0.004) and 5-year OS (78%; adjusted HR, 0.09; 95% CI, 0.02–0.38; P = 0.001).Conclusions: Among ovarian cancer patients, BRCA2 carriers with mutations located in the RAD51-BD (exon 11) have prolonged PFS, PFI, and OS. Clin Cancer Res; 24(2); 326–33. ©2017 AACR.
- Published
- 2023
59. Supplementary Tables 1-3, Supplementary Figure 1-2 from Location of Mutation in BRCA2 Gene and Survival in Patients with Ovarian Cancer
- Author
-
Isabelle Ray-Coquard, Valérie Bonadona, Lisa Golmard, Adrien Buisson, Dominique Stoppa-Lyonnet, Claude Houdayer, Marc-Henri Stern, Pierre O. Chappuis, Aurélie Ayme, Valeria Viassolo, Patrick Meraldi, Pierre Meeus, Sarah Stuckelberger, Pierre-Etienne Heudel, Olivier Tredan, Nicolas Chopin, Beata Rak, Patrick Petignat, Alexandre Bodmer, Olfa Derbel, Domenico Ferraioli, Manuel Rodrigues, Timothée Olivier, and S. Intidhar Labidi-Galy
- Abstract
Table S1: Multivariate Model of progression-free survival in the study cohort; Table S2: Multivariate Model of overall survival in the study cohort; Table S3: BRCA2 mutations in the study cohort; Figure S1: Flow diagram for selection of patients in the study cohort; Figure S2: A model for double-strand breaks repair by homologous recombination that depends on the location of mutation in BRCA2 gene.
- Published
- 2023
60. UPR-induced ovarian cancer cell fusion: a mechanism favoring drug resistance?
- Author
-
Melisa Husein, Patrick Petignat, and Marie Cohen
- Subjects
Cancer Research ,Oncology - Published
- 2023
61. Traitements intrapéritonéaux de la carcinose ovarienne : proposition d’algorithmes décisionnels
- Author
-
Manuela Undurraga, Patrice Mathevet, Martin Hubner, Nicolas C. Buchs, Maxime Warlaumont, Apostolos Sarivalasis, Antonella Diciolla, Noémie Lang, Thibaud Koessler, Antonia Digklia, Frédéric Ris, Patrick Petignat, and Intidhar Labidi-Galy
- Subjects
General Medicine - Published
- 2022
62. Nab-PIPAC: a phase IB study protocol of intraperitoneal cisplatin and nab-paclitaxel administered by pressurised intraperitoneal aerosol chemotherapy (PIPAC) in the treatment of advanced malignancies confined to the peritoneal cavity
- Author
-
Noemie Lang, Antonella Diciola, Intidhar Labidi-Galy, Frédéric Ris, Mariagrazia Di Marco, Nicolas Mach, Patrick Petignat, Christian Toso, Manuela Undurraga, and Martin Hubner
- Subjects
General Medicine - Abstract
IntroductionIntraperitoneal dissemination is a major problem resulting in very poor prognosis and a rapid marked deterioration in the quality of life of patients. Pressurised intraperitoneal aerosol chemotherapy (PIPAC) is an emergent laparoscopic procedure aiming to maximise local efficacy and to reduce systemic side effects.Methods and analysisNab-PIPAC, a bicentre open-label phase IB, aims to evaluate safety of nab-paclitaxel and cisplatin association using in patients with peritoneal carcinomatosis (PC) of gastric, pancreatic or ovarian origin as ≥1 prior line of systemic therapy. Using a 3+3 design, sequential intraperitoneal laparoscopic application of nab-paclitaxel (7.5, 15, 25, 37.5, 52.5 and 70 mg/m2) and cisplatin (10.5 mg/m2) through a nebuliser to a high-pressure injector at ambient temperature with a maximal upstream pressure of 300 psi. Treatment maintained for 30 min at a pressure of 12 mm Hg and repeated4–6 weeks intervals for three courses total.A total of 6–36 patients are expected, accrual is ongoing. Results are expected in 2024.The primary objective of Nab-PIPAC trial is to assess tolerability and safety of nab-paclitaxel and cisplatin combination administered intraperitoneally by PIPAC in patients with PC of gastric, pancreatic or ovarian origin. This study will determine maximum tolerated dose and provide pharmacokinetic data.Ethic and disseminationEthical approval was obtained from the ethical committees of Geneva and Vaud (CCER-2018-01327). The study findings will be published in an open-access, peer-reviewed journal and presented at relevant conferences and research meetings.Trial registration numberNCT04000906.
- Published
- 2023
63. Radiotherapy or Surgery of the Axilla After a Positive Sentinel Node in Breast Cancer: 10-Year Results of the Randomized Controlled EORTC 10981-22023 AMAROS Trial
- Author
-
Sanne A.L. Bartels, Mila Donker, Coralie Poncet, Nicolas Sauvé, Marieke E. Straver, Cornelis J.H. van de Velde, Robert E. Mansel, Charlotte Blanken, Lorenzo Orzalesi, Jean H.G. Klinkenbijl, Huub C.J. van der Mijle, Grard A.P. Nieuwenhuijzen, Sanne C. Veltkamp, Thijs van Dalen, Andreas Marinelli, Herman Rijna, Marko Snoj, Nigel J. Bundred, Jos W.S. Merkus, Yazid Belkacemi, Patrick Petignat, Dominic A.X. Schinagl, Corneel Coens, Geertjan van Tienhoven, Frederieke van Duijnhoven, Emiel J.T. Rutgers, Radiation Oncology, Radiotherapy, CCA - Cancer Treatment and Quality of Life, and CCA - Imaging and biomarkers
- Subjects
Cancer Research ,All institutes and research themes of the Radboud University Medical Center ,Oncology ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. PURPOSE The European Organisation for Research and Treatment of Cancer 10981-22023 AMAROS trial evaluated axillary lymph node dissection (ALND) versus axillary radiotherapy (ART) in patients with cT1-2, node-negative breast cancer and a positive sentinel node (SN) biopsy. At 5 years, both modalities showed excellent and comparable axillary control, with significantly less morbidity after ART. We now report the preplanned 10-year analysis of the axillary recurrence rate (ARR), overall survival (OS), and disease-free survival (DFS), and an updated 5-year analysis of morbidity and quality of life. METHODS In this open-label multicenter phase III noninferiority trial, 4,806 patients underwent SN biopsy; 1,425 were node-positive and randomly assigned to either ALND (n = 744) or ART (n = 681). RESULTS Per intention-to-treat analysis, 10-year ARR cumulative incidence was 0.93% (95% CI, 0.18 to 1.68; seven events) after ALND and 1.82% (95% CI, 0.74 to 2.94; 11 events) after ART (hazard ratio [HR], 1.71; 95% CI, 0.67 to 4.39). There were no differences in OS (HR, 1.17; 95% CI, 0.89 to 1.52) or DFS (HR, 1.19; 95% CI, 0.97 to 1.46). ALND was associated with a higher lymphedema rate in updated 5-year analyses (24.5% v 11.9%; P < .001). Quality-of-life scales did not differ by treatment through 5 years. Exploratory analysis showed a 10-year cumulative incidence of second primary cancers of 12.1% (95% CI, 9.6 to 14.9) after ART and 8.3% (95% CI, 6.3 to 10.7) after ALND. CONCLUSION This 10-year analysis confirms a low ARR after both ART and ALND with no difference in OS, DFS, and locoregional control. Considering less arm morbidity, ART is preferred over ALND for patients with SN-positive cT1-2 breast cancer.
- Published
- 2023
64. 2022-RA-566-ESGO Cost-effectiveness of cervical cancer screnning strategies among women in Cameroon
- Author
-
Jessica Sormani, Ania Wisniak, Bruno Kenfack, Alida Moukam Datchoua, Pierre Vassilakos, Patrick Petignat, and Christophe Combescure
- Published
- 2022
65. 'Cervical cancer screening: awareness is not enough'. Understanding barriers to screening among women in West Cameroon—a qualitative study using focus groups
- Author
-
Patrick Petignat, Pierre Vassilakos, Muriel Samartha Embolo Owono, Alida Manoëla Datchoua Moukam, Bruno Kenfack, Nicole Schmidt, and Jessica Sormani
- Subjects
Adult ,Male ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,Attitude of Health Personnel ,Uterine Cervical Neoplasms ,Health literacy ,Health Services Accessibility ,03 medical and health sciences ,0302 clinical medicine ,Health care ,medicine ,Humans ,Mass Screening ,030212 general & internal medicine ,Cameroon ,Early Detection of Cancer ,Qualitative Research ,Cervical cancer ,Sub-Saharan Africa ,business.industry ,Public health ,Research ,Prevention ,Obstetrics and Gynecology ,Gynecology and obstetrics ,Focus Groups ,Middle Aged ,medicine.disease ,Focus group ,Reproductive Medicine ,030220 oncology & carcinogenesis ,Family medicine ,RG1-991 ,Female ,Rural area ,Thematic analysis ,business ,Barriers ,Qualitative research - Abstract
Background Cervical cancer is the second leading cause of cancer-related death among women in sub-Saharan countries, constituting a major public health concern. In Cameroon, cervical cancer ranks as the second most common type of cancer among women and the leading cause of cancer-related deaths, mainly due to the lack of prevention. Objectives Our first and main objective was to understand the barriers affecting women’s decision-making process regarding participation in a cervical cancer screening program in the Dschang district (West Cameroon). Second, we aimed to explore the acceptability and perception of a single-visit approach (screen and treat). Methods A qualitative study using focus groups (FGs) was conducted from February to March 2020. Female participants aged between 30 and 49 years and their male partners were invited to participate. Thematic analysis was used, and barriers were classified according to the three-delay model of Thaddeus and Maine. Results In total, six FGs with 43 participants (31 women and 12 men) were conducted. The most important barriers were lack of health literacy, low accessibility of the program (in respect to cost and distance), and disrespectful treatment by healthcare workers. Conclusions Our study identified three needs: (1) enhancing health literacy; (2) improving the delivery of cervical cancer screening in rural areas; and (3) providing training for healthcare providers and community healthcare workers to improve patient-provider-communication. Trial registration Ethical Cantonal Board of Geneva, Switzerland (CCER, N°2017-0110 and CER-amendment n°3) and Cameroonian National Ethics Committee for Human Health Research (N°2018/07/1083/CE/CNERSH/SP). NCT: 03757299, Plain Language Summary Cervical cancer is the second leading cause of cancer-related death among women in sub-Saharan countries, constituting a major public health concern. In Cameroon, cervical cancer ranks as the second most common type of cancer among women and is the leading cause of cancer-related deaths, mainly due to the lack of prevention measures, such as cervical cancer screening. The main aim of the current study was to understand barriers that affect women’s decision-making processes regarding participation in a cervical cancer screening program in the Dschang district in West Cameroon. A qualitative study methodology using focus group discussions was conducted from February to March 2020. Female participants aged between 30 and 49 years and their male partners were invited to participate. In total, six discussion groups with 43 participants (31 women and 12 men) were conducted. The most important barriers were a lack of health literacy, limited access to the program because of cost and distance, and disrespectful treatment by healthcare workers. Our results identified three key areas for improvement: first, increasing health literacy; second, providing cervical cancer screening in rural areas; and third, training healthcare providers and community healthcare workers in better patient-provider-communication.
- Published
- 2021
66. [Intraperitoneal therapy for carcinomatosis in ovarian cancer: proposed treatment algorithm]
- Author
-
Manuela, Undurraga, Patrice, Mathevet, Martin, Hubner, Nicolas C, Buchs, Maxime, Warlaumont, Apostolos, Sarivalasis, Antonella, Diciolla, Noémie, Lang, Thibaud, Koessler, Antonia, Digklia, Frédéric, Ris, Patrick, Petignat, and Intidhar, Labidi-Galy
- Subjects
Ovarian Neoplasms ,Antineoplastic Combined Chemotherapy Protocols ,Carcinoma ,Humans ,Female ,Cytoreduction Surgical Procedures ,Hyperthermia, Induced ,Hyperthermic Intraperitoneal Chemotherapy ,Neoplasm Recurrence, Local ,Algorithms ,Peritoneal Neoplasms - Abstract
Ovarian cancer is the first cause of death by gynecological cancer. Most of the patients are diagnosed with peritoneal carcinomatosis that represents a therapeutic challenge. Its management implies maximal cytoreductive surgery with survival benefit. Over the last three decades, several strategies of intra-peritoneal chemotherapy have been investigated. This includes intra-peritoneal adjuvant chemotherapy that is used mainly in North America, hyperthermic intraperitoneal chemotherapy (HIPEC) and more recently pressurized intraperitoneal aerosol chemotherapy (PIPAC). In the current article, we review the evidence in favor of each therapeutic approach, and we propose treatment algorithms depending on the clinical situation of ovarian cancer patients: upfront, platinum-sensitive and platinum-resistant relapse.Le cancer de l’ovaire est la première cause de décès par cancer gynécologique. La plupart des patientes sont diagnostiquées au stade de carcinose péritonéale qui représente un défi thérapeutique. Sa prise en charge chirurgicale implique une cytoréduction maximaliste. Au cours des 30 dernières années, plusieurs stratégies de chimiothérapie intrapéritonéale ont été testées afin d’améliorer le contrôle de la carcinose péritonéale. Il s’agit des chimiothérapies intrapéritonéale adjuvante utilisée surtout en Amérique du Nord, hyperthermique intrapéritonéale (CHIP) et intrapéritonéale pressurisée en aérosols (PIPAC). Dans cet article, nous reprenons les données de la littérature sur chacune de ces trois approches thérapeutiques et proposons des algorithmes décisionnels selon la situation clinique des patientes traitées pour un cancer de l’ovaire : au diagnostic, récidive platine-sensible et platine-résistante.
- Published
- 2022
67. A cross-sectional study exploring triage of human papillomavirus (HPV)-positive women by visual assessment, manual and computer-interpreted cytology, and HPV-16/18–45 genotyping in Cameroon
- Author
-
Patrick Petignat, Jean-Christophe Tille, Bruno Kenfack, Eveline Tincho Foguem, Ania Wisniak, Pierre Vassilakos, Essia Saiji, Christine Balli, and Rosa Catarino
- Subjects
Adult ,medicine.medical_specialty ,Genotype ,cervical cancer ,Cross-sectional study ,ddc:616.07 ,03 medical and health sciences ,0302 clinical medicine ,Cytology ,Visual assessment ,Humans ,Medicine ,Cameroon ,030212 general & internal medicine ,Human papillomavirus ,Genotyping ,Cervix ,Early Detection of Cancer ,Original Research ,Colposcopy ,Human papillomavirus 16 ,ddc:618 ,Human papillomavirus 18 ,medicine.diagnostic_test ,business.industry ,Obstetrics ,Papillomavirus Infections ,Obstetrics and Gynecology ,Middle Aged ,Triage ,female genital diseases and pregnancy complications ,Cross-Sectional Studies ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,pathology ,Female ,business - Abstract
BackgroundHigh-risk human papillomavirus (HPV)-positive women require triage to identify those at higher risk of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). We aimed to compare visual assessment of the cervix, manual cytology and automated cytology as triage tests to screen HPV-positive women, and to assess over-treatment rates after visual assessment and over-referral rates to colposcopy after cytology.MethodsThe present cross-sectional study is nested in a large prospective screening trial in Cameroon. Evaluations of the tests have been conducted individually and in combination with HPV-16/HPV-18/45 genotyping. For the evaluation of over-treatment and colposcopic over-referral, we simulated two screening scenarios: (1) one-visit scenario (test-triage-and-treatment); and (2) two-visit scenario (test-triage-and-colposcopy).Results1582 women with a median age of 40 years (IQR 35–45) performed self-sampling for HPV testing, of which 294 (18.6%) were HPV-positive, and 12.2% had CIN2+. Sensitivities for CIN2+ detection were 77.1% for visual assessment, 80.0% for manual cytology, and 84.8% for automated cytology. Sensitivity of combined tests was higher compared with single tests. The highest sensitivity was obtained by the combination of genotyping and automated cytology (91.2%). In the one-visit scenario, the over-treatment rate was 83.9% in referred women, with a ratio of 6.2 treated women per CIN2+. In the two-visit scenario, the lowest over-referral rate would have been under manual cytology (45.0%), with a ratio of 1.8 referred women per CIN2+. Single and combined triage strategies by automated cytology gave rise to over-referral rates of 69.2% and 76.7%, respectively, and a ratio of 3.2 and 4.3 referred women per CIN2+, respectively.DiscussionTriage of HPV-positive women using a combination of genotyping and automated cytology for CIN2+ detection may provide public benefits in low- and middle-income countries.
- Published
- 2021
68. A Cross-sectional Study on the Prevalence of Cervical Dysplasia Among Women With Female Genital Mutilation/Cutting
- Author
-
Patrick Petignat, Alicia Azuaga Martinez, Emily Manin, Jasmine Abdulcadir, and Manuela Undurraga Malinverno
- Subjects
Adult ,Female circumcision ,medicine.medical_specialty ,Cross-sectional study ,Population ,Uterine Cervical Neoplasms ,03 medical and health sciences ,0302 clinical medicine ,Abnormal PAP Smear ,Prevalence ,medicine ,Humans ,education ,Papillomaviridae ,Transients and Migrants ,education.field_of_study ,030219 obstetrics & reproductive medicine ,Obstetrics ,business.industry ,Medical record ,Papillomavirus Infections ,Obstetrics and Gynecology ,General Medicine ,Middle Aged ,Uterine Cervical Dysplasia ,medicine.disease ,Squamous intraepithelial lesion ,Cross-Sectional Studies ,Dysplasia ,030220 oncology & carcinogenesis ,Circumcision, Female ,Carcinoma, Squamous Cell ,Female ,business ,Ascus ,Switzerland - Abstract
Objective The aim of the study was to assess the prevalence of cervical dysplasia among migrant women with female genital mutilation/cutting (FGM/C) at a specialized clinic in Switzerland. Materials and methods This is a descriptive retrospective cross-sectional study. We reviewed the electronic medical records of all women who attended a specialized FGM/C clinic at the Geneva University Hospitals between 2010 and 2016. We examined sociodemographic data, sexually transmitted infections, FGM/C types, Pap smear results, and follow-up in women diagnosed with cervical dysplasia. Results Three hundred sixty records were reviewed and 338 women were included. The average age was 33 years (SD = 7.47 years). Most women were from Eritrea and Somalia (n = 204, 60.4%) and had FGM/C type III (n = 188, 55.6%). A total of 12.4% (n = 42) of the patients had abnormal Pap smears: 1.5% (n = 5) with atypical squamous cells of undetermined significance (ASCUS) with high-risk human papillomavirus (HPV), 7.9% (n = 27) with low-grade squamous intraepithelial lesion (LSIL), and 2.9% (n = 10) with high-grade squamous intraepithelial lesion or higher (HSIL +). Of the 37 patients with dysplasia, 22 (59.4%) completed follow-up and 15 (40.5%) received incomplete follow-up. Conclusions The prevalence of high-grade squamous intraepithelial lesion+ among migrant women with FGM/C is high (2.95%) compared with the general Swiss population (0.58%). Follow-up for cervical dysplasia must be improved by increasing provider knowledge of this patient population and by addressing barriers to care.
- Published
- 2021
69. Description of Maternal Morbidities Amongst 1000 Women During Pregnancy in Ambanja, Madagascar – Opportunities and Challenges of Using an mHealth System
- Author
-
Elisabeth Garcia Vilaplana, Jessica Sormani, Nicole C Schmidt, Adelia Soaroby, Pierre Vassilakos, Anne-Caroline Benski, and Patrick Petignat
- Subjects
Pregnancy ,030219 obstetrics & reproductive medicine ,business.industry ,Anemia ,Obstetrics and Gynecology ,Standardized test ,medicine.disease ,maternal health ,anemia ,Gestational diabetes ,03 medical and health sciences ,0302 clinical medicine ,Who recommendations ,antenatal care ,Oncology ,Environmental health ,Maternity and Midwifery ,Medicine ,Population study ,030212 general & internal medicine ,business ,maternal deaths ,mHealth ,Malaria ,Original Research - Abstract
Background The estimated burden of maternal morbidities in lower-income countries, such as Madagascar, is high. However, there is still a lack of data on maternal morbidities, in part due to an absence of standardized assessment tools. This cross-sectional study aims to report maternal morbidities among 1015 women in the district of Ambanja, Madagascar, and to describe the advantages and limitations of a mHealth system. Methods Data were collected using the PANDA (pregnancy and newborn diagnosis assessment) system, an mHealth device that incorporates the WHO recommendations for antenatal care (ANC). Data, including personal and medical information, but also clinical data such as hypertension, anemia or HIV were collected from more than 1000 women attending ANC. Results A total of 1015 pregnant women were recruited from January 2015 to August 2018. The average age was 24.6 years old, and most women were married (82.3%). The majority lived in urban areas and were unemployed. Prevalence of hypertension and gestational diabetes was relatively low (4% vs 2.2%). Malaria infection was diagnosed in 2.2% and HIV was diagnosed in 1.2% of pregnant women. The most common morbidity was anemia (68.4%) and the only significant factor associated was being single compared to being married (OR 1.68, 95% CI 1.05–2.70, p-value 0.032). Discussion The prevalence of anemia in our study population was much higher than previously reported in Sub-Saharan Africa. This finding highlights the need for regular iron supplementation during pregnancy, especially in vulnerable (eg, single) women. The PANDA mHealth system provides unique opportunities due to its standardization of ANC and creation of a digital database accessible from a distance. However, one of the main challenges was that even a mHealth system such as the PANDA remains dependent on the local procurement chain. Therefore, future studies need to access opportunities of mHealth systems to support health service delivery. Trial Registration Registered on ISRCTN on 14th October 2015, number ISRCTN18270380. Retrospectively registered.
- Published
- 2020
70. Implementing the 3T‐approach for cervical cancer screening in Cameroon: Preliminary results on program performance
- Author
-
Patrick Petignat, Marie de Preux, Jessica Sormani, Chloé Frund, Pierre Vassilakos, Juliette Levy, Eveline Tincho, Bruno Kenfack, Rosa Catarino, and Jovanny Tsuala Fouogue
- Subjects
0301 basic medicine ,Adult ,Cancer Research ,medicine.medical_specialty ,Referral ,Single visit ,cervical cancer ,Thermal ablation ,Uterine Cervical Neoplasms ,Alphapapillomavirus ,Cervical cancer screening ,lcsh:RC254-282 ,World health ,Human Papillomavirus DNA Tests ,Specimen Handling ,03 medical and health sciences ,0302 clinical medicine ,prevention ,Predictive Value of Tests ,Internal medicine ,medicine ,Electrocoagulation ,Humans ,Radiology, Nuclear Medicine and imaging ,Cameroon ,screen‐and‐treat ,Early Detection of Cancer ,Original Research ,Cervical cancer ,business.industry ,Papillomavirus Infections ,Middle Aged ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Triage ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,DNA, Viral ,Patient Compliance ,Female ,Performance indicator ,business ,Precancerous Conditions ,Cancer Prevention ,management ,sub‐Saharan Africa ,Program Evaluation - Abstract
Option recommended by World Health Organization (WHO) includes human papillomavirus (HPV) primary screening followed by visual inspection with acetic acid (VIA) triage. We implemented a program based on a 3T‐approach (Test‐Triage and Treat). Our objective was to verify the effectiveness of the program by defining a set of performance indices. A sensitization campaign was performed in Dschang (Cameroon) and women aged 30‐49 years were invited to participate for screening based on the 3T‐approach. Participants performed HPV self‐sampling (Self‐HPV), analyzed with the point‐of‐care Xpert HPV assay followed by VIA/VILI triage and treatment if required. Key performance indicators (KPIs) for screening, diagnosis, treatment and follow‐up were defined, and achievable targets were described for which the approach is likely to be running optimally. A total of 840 women with a mean age of 39.4±5.9 years participated. The KPIs included (i) the screening rate (8.4% at 7 months, target =20% at 12 months), (ii) HPV positivity rate (19.8%, expected range 18‐25%), (iii) compliance to referral to VIA/VILI and complete test (100%, target >90%), (iv) compliance to referral to thermal ablation (100%, target >90%), (v) VIA/VILI positivity rate (50.6%, expected range 45‐55%), (vi) a single visit from diagnostic to treatment (79.8%, target >80%), (vii) compliance to follow‐up at 1 month (96.4%, target >80%) and (viii) at 6 months (70.6%, target >80%). Program performance based on the single‐visit 3T‐approach corresponded to defined targets and preliminary results support adequateness of KPIs for periodic monitoring., The study shows the performance of screening for cervical cancer in a single visit, using the 3T strategy, for Test‐Triage and Treat in low‐income countries Our results will be of great interest especially those designing and conducting women’s health screening programs in low‐income countries. Improved primary screening, diagnosis, treatment, and follow‐up, such as in the single‐visit 3T approach to screen cervical cancer in Cameroon, will substantially reduce the incidence of preventable or treatable diseases in low‐ and middle‐income countries.
- Published
- 2020
71. In Vivo Imaging–Based 3-Dimensional Pelvic Prototype Models to Improve Education Regarding Sexual Anatomy and Physiology
- Author
-
Diomidis Botsikas, Jorge Remuinan, Patrick Petignat, Jasmine Abdulcadir, Natacha Firmenich, Romain Dewaele, and Céline Brockmann
- Subjects
Male ,Models, Anatomic ,Sexual Behavior ,Urology ,Endocrinology, Diabetes and Metabolism ,Population ,030232 urology & nephrology ,Physiology ,Clitoris ,Sex Education ,Sexual Response ,ddc:616.0757 ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Endocrinology ,Clitoral Reconstruction ,Sexual medicine ,medicine ,Humans ,Sex organ ,education ,Retrospective Studies ,Reproductive health ,education.field_of_study ,ddc:618 ,Anatomy Education ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,Female Genital Mutilation ,Magnetic resonance imaging ,Anatomy ,Magnetic Resonance Imaging ,3D Printing ,Psychiatry and Mental health ,Cross-Sectional Studies ,medicine.anatomical_structure ,Reproductive Medicine ,Female ,business ,Penis ,Preclinical imaging ,MRI ,Model - Abstract
Background Myths, misconceptions, and taboos about sexual anatomy and physiology are common and can affect sexual health and maintain harmful practices and beliefs. Aim To construct a female and a preliminary male 3-dimensional (3D) pelvic model on the basis of in vivo imaging, which could be studied in sex education and clinical practice. Methods We retrospectively studied the images of 200 female pelvic magnetic resonance examinations and reviewed the literature to choose the optimum magnetic resonance imaging (MRI) protocol for the study of the clitoris and surrounding organs. We also conducted a cross-sectional study of 30 women who were undergoing a pelvic MRI. 15 women had undergone female genital mutilation/cutting involving the clitoris and 15 had not. The best-quality MRI images of 3 uncut and 1 cut clitoris, together with the principal surrounding pelvic organs, were selected to generate 3D reconstructions using dedicated software. The same software was used to reconstruct the anatomy of the penis and the principal surrounding pelvic organs, based on contrast-enhanced computer tomography images. Images of both models were exported in .stl format and cleaned to obtain single manifold objects in free, open source software. Each organ model was sliced and 3D printed. A preliminary feedback was collected from 13 potential users working in urology, gynaecology, sexual medicine, physiotherapy, and education. Outcomes The main outcomes of this study are a kit of 3D pelvic models, 2-dimensional figures of female and male sexual anatomy, and files for 3D printing. Results We present a kit containing 3D models and 2-dimensional figures of female and male sexual anatomy, based on in vivo imaging and, feedbacks and suggestions received from potential users. Clinical Translation Our kit can be used in anatomy and sex education among and by health professionals, teachers, sex educators, students, and the general population. Strengths & Limitations The strengths are that the models were based on in vivo imaging, can be dismantled/reassembled, and show analogous anatomic structures of the clitoris and the penis. The female models represent diversity, including women with female genital mutilation/cutting. The limitations are that the male model is preliminary and can be improved if based on an MRI; that imaging-based anatomic representations can differ from anatomic dissections; and that the models represent the sexual organs at rest or during an unknown state of arousal only. Conclusion Our kit can be studied in anatomy, biology, and sex education, as well as in clinical practice.
- Published
- 2020
72. Prognostic factors and long‐term outcomes of obstetric fistula care using the Tanguiéta model
- Author
-
Rosa Catarino, Abdoulaye Doulougou, Pierre Vassilakos, Charles-Henry Rochat, Valérie Elsig, Manuela Viviano, Anne-Caroline Benski, Patrick Petignat, and Martine Delavy
- Subjects
Adult ,medicine.medical_specialty ,Fistula ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Pregnancy ,Multidisciplinary approach ,Burkina Faso ,medicine ,Humans ,030212 general & internal medicine ,Socioeconomic status ,Retrospective Studies ,Surgical repair ,ddc:618 ,030219 obstetrics & reproductive medicine ,Vesicovaginal Fistula ,business.industry ,General surgery ,Obstetrics and Gynecology ,Retrospective cohort study ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Treatment Outcome ,Quality of Life ,Female ,sense organs ,Vesicovaginal Fistula/psychology/surgery ,business - Abstract
OBJECTIVES To identify factors influencing the long-term prognosis after surgical repair of obstetric fistula, establish a prognosis-based classification system, and examine changes in quality of life after surgery. METHODS A retrospective study of 308 women who underwent obstetric fistula repair at Saint Jean de Dieu Hospital, Tanguieta, Benin, between 2008 and 2016, and were supported by a multidisciplinary management model. All participants were from rural areas of Burkina Faso. The women completed interviews before, immediately after, and 2, 4-6, and 12 months after surgery to assess their clinical state and socioeconomic and psychologic status. RESULTS Overall, the fistulae of 230/274 (83.9%) women were considered to be repaired after 12 months. Factors associated with poor repair outcome included the presence of sclerotic tissue (odds ratio [OR], 0.25; 95% confidence interval [CI], 0.11-0.53) and intraoperative complications (OR, 0.16; 95% CI, 0.07-0.39). Women with successful surgery had a better quality of life as compared with women with an unrepaired fistula (Ditrovie score, 1.1 vs 3.9; P
- Published
- 2020
73. Development of a Pedf Gene Delivery System Against Ovarian Cancer
- Author
-
Pascale Ribaux, Christine Wuillemin, Patrick Petignat, Florence Delie, and marie cohen
- Subjects
History ,Polymers and Plastics ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2022
74. Machine Learning-Based Cervical Cancer Screening Using Cervigrams During Visual Inspection With Acetic Acid: a Systematic Review
- Author
-
Roser Viñals, Magali Cattin, Patrick Petignat, Jean-Philippe Thiran, and Pierre Vassilakos
- Abstract
Background: The World Health Organization (WHO) recommendations for promoting effective management of cervical cancer screening in low- and medium-income countries (LMIC) include human papillomavirus (HPV) testing as primary screening followed by visual inspection with acetic acid (VIA) and, if required, treatment. The application of acetic acid induces a transient whitening effect which appears and disappears differently in precancerous lesions and cancer than in benign conditions. However, this assessment by human observers is generally subjective and accuracy is limited. This study presents a systematic review of the automated algorithms for cervical (pre)cancer screening based on images taken during VIA with the objective of assessing their potential as screening tool.Methods: We performed a systematic literature search in PubMed, Google Scholar and Scopus. The selected studies introduce automated algorithms for the classification of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) with respect to benign conditions, based only on images taken during VIA. We included studies that use, as gold standard, histopathology for CIN2+ cases and, histopathology or normal cytology and colposcopy for benign conditions. The selected studies were analysed in terms of specificity and sensitivity. From each study, the algorithm with the highest accuracy was further studied considering key features such as type of algorithms, acquisition devices, the number of images used per patient, or its performance in comparison to the experts’ classification. The quality and risk of the studies was assessed following the QUADAS-2 guidelines.Results: Of the 1519 studies identified, nine met the inclusion criteria. The algorithms with the highest accuracy from each study reported a sensitivity and specificity values ranging from 0.60 to 0.93 and 0.67 to 0.95, respectively. Conclusion: Machine learning-based cervical cancer screening algorithms have the potential to become a key tool for cervical cancer screening in countries that suffer from a lack of healthcare infrastructure and personnel. Nevertheless, the selected studies assess their algorithms using small datasets made of highly selected images without reflecting real screened populations. Large-scale and real conditions testing is required to assess the potential of these algorithms as the future of cervical cancer screening.Systematic review registration: PROSPERO CRD42021270745
- Published
- 2021
75. Exploring Factors Associated with Patients Who Prefer Clinician-Sampling to HPV Self-Sampling: A Study Conducted in a Low-Resource Setting
- Author
-
Pierre Vassilakos, Nicole C Schmidt, Alida Moukam Datchoua, Bruno Kenfack, Patrick Petignat, Jessica Sormani, Ania Wisniak, and Sophie Lemoupa Makajio
- Subjects
sub-Saharan Africa ,Adult ,obstetrics_gynaecology ,Low resource ,Health, Toxicology and Mutagenesis ,cervical cancer screening ,Uterine Cervical Neoplasms ,Alphapapillomavirus ,Cervical cancer screening ,Article ,Specimen Handling ,Environmental health ,HPV self-sampling ,preference ,Medicine ,Humans ,Mass Screening ,Papillomaviridae ,Early Detection of Cancer ,business.industry ,Papillomavirus Infections ,Public Health, Environmental and Occupational Health ,Sampling (statistics) ,Middle Aged ,Preference ,Self Care ,Female ,business ,Self sampling - Abstract
Human papillomavirus (HPV) self-sampling (Self-HPV) is a promising strategy to improve cervical cancer screening coverage in low-income countries. However, issues associated with women who prefer conventional HPV clinical-sampling over HPV self-sampling may affect screening participation. To address this issue, our study assessed factors associated with women’s preferences related to Self-HPV. This study was embedded in a large clinical trial recruiting women aged 30–49 years in a primary HPV-based study termed “3T-Approach” (for Test-Triage-Treatment), launched in 2018 at Dschang District Hospital, West Cameroon. Participants were invited to perform a Self-HPV. After the sampling and before receiving the results, participants completed a questionnaire about cervical cancer screening and their preferences and perceptions around Self-HPV. The median age of the 2201 participants was 40.6 (IQR 35–45) years. Most (1693 (76.9%)) preferred HPV self-sampling or had no preference for either method and 508 (23.1%) preferred clinician-sampling. Factors associated with an increased likelihood of reporting a clinician-sampling preference were tertiary educational level (14.4% CI: 12.8–16.1 vs 29.5% CI: 25.6–33.6) and being an employee with higher grade professional or managerial occupations (5.5% CI: 3.8–7.9 vs 2.6% CI: 2.3–2.8). The main reported reason for women preferring clinician-sampling was a lack of “self-expertise”. Most women (>99%) would agree to repeat HPV self-sampling and would recommend it to their relatives. HPV self-sampling in the cultural context of central Africa was well accepted by participants, but some participants would prefer to undergo clinician sampling. Health systems should support well-educated women to increase self-confidence in using HPV self-sampling.
- Published
- 2021
76. Fast-Track in Minimally Invasive Gynecology: A Randomized Trial Comparing Costs and Clinical Outcomes
- Author
-
Nicola Pluchino, Patrick Dällenbach, Georges L. Savoldelli, Jean Dubuisson, Philippe Brossard, Benno Rehberg-Klug, Shahzia Lambat Emery, Jean-Marie Wenger, Patrick Petignat, and Michel Boulvain
- Subjects
medicine.medical_specialty ,RD1-811 ,laparoscopic hysterectomy (LH) ,business.industry ,hospital costs ,post-operative morbidity ,fast-track ,Pain management ,Clinical Trial ,hospital stay ,law.invention ,Surgery ,Clinical trial ,Patient satisfaction ,Randomized controlled trial ,law ,Pain assessment ,Ambulatory ,pain assessment ,Medicine ,Fast track ,business ,Hospital stay - Abstract
Study Objective: Evaluate the effects of a fast-track (FT) protocol on costs and post-operative recovery.Methods: One hundred and seventy women undergoing total laparoscopic hysterectomy for a benign indication were randomized in a FT protocol or a usual care protocol. A FT protocol included the combination of minimally invasive surgery, analgesia optimization, early oral refeeding and rapid mobilization of patients was compared to a usual care protocol. Primary outcome was costs. Secondary outcomes were length of stay, post-operative morbidity and patient satisfaction.Main Results: The mean total cost in the FT group was 13,070 ± 4,321 Euros (EUR) per patient, and that in the usual care group was 3.5% higher at 13,527 ± 3,925 EUR (p = 0.49). The FT group had lower inpatient surgical costs but higher total ambulatory costs during the first post-operative month. The mean hospital stay in the FT group was 52.7 ± 26.8 h, and that in the usual care group was 20% higher at 65.8 ± 33.7 h (p = 0.006). Morbidity during the first post-operative month was not significantly different between the two groups. On their day of discharge, the proportion of patients satisfied with pain management was similar in both groups [83% in FT and 78% in the usual care group (p = 0.57)]. Satisfaction with medical follow-up 1 month after surgery was also similar [91% in FT and 88% in the usual care group (p = 0.69)].Conclusion: Implementation of a FT protocol in laparoscopic hysterectomy for benign indications has minimal non-significant effects on costs but significantly reduces hospital stay without increasing post-operative morbidity nor decreasing patient satisfaction.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04839263.
- Published
- 2021
77. Utility of extended HPV genotyping for the triage of self-sampled HPV-positive women in a screen-and-treat strategy for cervical cancer prevention in Cameroon: a prospective study of diagnostic accuracy
- Author
-
Celine Broquet, Pierre Vassilakos, François Marcel Ndam Nsangou, Bruno Kenfack, Michel Noubom, Evelyn Tincho, Emilien Jeannot, Ania Wisniak, and Patrick Petignat
- Subjects
General Medicine - Abstract
ObjectiveTo explore the utility of extended Human Papillomavirus (HPV) genotyping to detect cervical intraepithelial neoplasia grade 2 or more (CIN2+) in a ‘screen-and-treat’ strategy for HPV-positive women in low-resource settings.DesignProspective study of diagnostic accuracy.SettingThe study took place in West Cameroon between September 2018 and March 2020.Participants2014 women were recruited. Asymptomatic, non-pregnant women aged 30–49 years without history of CIN treatment, anogenital cancer or hysterectomy were eligible.InterventionsParticipants performed self-sampling for HPV testing with GeneXpert followed by visual inspection with acetic acid and Lugol’s iodine (VIA) triage before treatment if required.Main outcome measuresLiquid-based cytology, biopsies and endocervical brushing were performed in HPV-positive women as quality control. We assessed the detection rate of CIN2+ by HPV genotyping (two pools of genotypes obtained from the Xpert system, pool_1 (HPV 16, 18, 45) and pool_2 (HPV 16, 18, 45, 31, 33, 35, 52, 58)), VIA and cytology.Results382 (18.2%) women were HPV-positive among which 11.5% (n=44) were CIN2+. Of those 44 participants, 41 were triaged positive by extended genotyping, versus 35 by VIA and 33 by cytology. Overall, triage positivity was of 68.4% for extended genotyping, 59.3% for VIA and 14.8% for cytology, with false positive rates of 83.4%, 84.1% and 37.7%, respectively. Extended genotyping had a higher sensitivity for CIN2+ detection (93.2%, CI: 81.3 to 98.6) than VIA (79.5%, CI: 64.7 to 90.2, p=0.034) and cytology (75.0%, CI: 59.7 to 86.8, p=0.005). No significant difference was observed in the overtreatment rate in triaged women by extended genotyping or VIA (9.9%, CI: 8.6 to 11.3, and 8.8%, CI: 7.7 to 10.1), with a ratio of 6.0 and 6.3 women treated per CIN2+ diagnosed.ConclusionTriage of HPV-positive women with extended HPV genotyping improves CIN2+ detection compared with VIA with a minor loss of specificity and could be used to optimize the management of HPV-positive women.Trial registration numberNCT03757299.
- Published
- 2022
78. Operative Complications and Outcomes Comparing Small and Large Uterine Weight in Case of Laparoscopic Hysterectomy for a Benign Indication
- Author
-
Michel Boulvain, Patrick Petignat, Shahzia Lambat Emery, and Jean Dubuisson
- Subjects
medicine.medical_specialty ,RD1-811 ,laparoscopic hysterectomy (LH) ,medicine.medical_treatment ,Endometriosis ,Statistical difference ,operative outcomes ,law.invention ,morcellation of the uterus ,Randomized controlled trial ,law ,Secondary analysis ,medicine ,Adenomyosis ,operative complications ,Original Research ,Hysterectomy ,business.industry ,urogenital system ,Laparoscopic hysterectomy ,medicine.disease ,Surgery ,Leiomyoma ,business ,uterine weight - Abstract
Study Objective: This study was performed to evaluate the association between uterine weight and operative outcomes in women undergoing laparoscopic hysterectomy for a benign indication.Methods: This is a secondary analysis of a randomized trial with data collected prospectively and retrospectively. The data of 159 women undergoing laparoscopic hysterectomy for a benign indication were analyzed. Women were divided in two groups according to the postoperative uterine weight: small uterus group (Main Results: Operative complications were not significantly different between the two groups (37% in the large uterus group versus 41% in the small uterus group). Operative outcomes showed a significantly increased use of uterine morcellation in the large uterus group (61% in the large uterus group versus 10% in the small uterus group). The operative duration was 150 min in the small uterus group and 176 min in the large uterus group, which corresponds to an increase of 17% in the large uterus group. The mean pain score on the day of surgery was identical in both groups (VAS pain score 5), but significantly in favor of the large uterus group on day 1 postoperatively (VAS pain score 4 in the small uterus group and 3 in the large uterus group). There was no statistical difference between groups in the mean hospital stay (62 ± 37 hours in the small uterus group versus 54 ± 21 hours in the large uterus group). In terms of surgical indication, the small uterus group comprised more patients with endometriosis/adenomyosis (36%) and the large uterus group more patients with leiomyoma (93%).Conclusion: The results from this study show that, even if a large uterine weight is associated with increased uterine morcellation requirement and operative duration, a laparoscopic approach is safe and does not increase operative complications nor pain and/or length of hospital stay in women undergoing hysterectomy for a benign indication.
- Published
- 2021
79. Blood-Based Multi-Cancer Detection Using a Novel Variant Calling Assay (DEEPGENTM): Early Clinical Results
- Author
-
Frédéric Ris, Stefan Moenig, Leo Hans Buehler, Christian Toso, Minia Hellan, Yanghee Woo, Jorge Nieva, David A. Geller, Rebecca Tuttle, Wolfram Karenovics, Nael Ismail, Frédéric Triponez, Debashish Bose, Patrick Petignat, Manuela Undurraga Malinervo, Giang Thanh Lam, James R. Ouellette, Jonathan Douissard, Christophe Iselin, and Nicolas C. Buchs
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Cancer detection ,Malignancy ,Cancer screening ,cell-free DNA ,Cell-free DNA ,Internal medicine ,medicine ,Stage (cooking) ,Liquid biopsy ,early detection ,Machine-learning ,RC254-282 ,Clinical pathology ,ddc:617 ,liquid biopsy ,business.industry ,machine-learning ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Cancer ,Early detection ,DEEPGENTM ,medicine.disease ,cancer detection ,Cell-free fetal DNA ,cancer screening ,business - Abstract
This is an early clinical analysis of the DEEPGENTM platform for cancer detection. Newly diagnosed cancer patients and individuals with no known malignancy were included in a prospective open-label case-controlled study (NCT03517332). Plasma cfDNA that was extracted from peripheral blood was sequenced and data were processed using machine-learning algorithms to derive cancer prediction scores. A total of 260 cancer patients and 415 controls were included in the study. Overall, sensitivity for all cancers was 57% (95% CI: 52, 64) at 95% specificity, and 43% (95% CI: 37, 49) at 99% specificity. With 51% sensitivity and 95% specificity for all stage 1 cancers, the stage-specific sensitivities trended to improve with higher stages. Early results from this preliminary clinical, prospective evaluation of the DEEPGENTM liquid biopsy platform suggests the platform offers a clinically relevant ability to differentiate individuals with and without known cancer, even at early stages of cancer.
- Published
- 2021
- Full Text
- View/download PDF
80. Acceptability and Safety of Thermal Ablation to Prevent Cervical Cancer in Sub-Saharan Africa
- Author
-
Jessica Sormani, Eveline Tincho, Patrick Petignat, Tania Metaxas, Ania Wisniak, Pierre Vassilakos, Bruno Kenfack, and Sophie Lemoupa Makajio
- Subjects
Adult ,Cancer Research ,Sub saharan ,Thermal ablation ,Uterine Cervical Neoplasms ,Environmental health ,Genetics ,medicine ,Humans ,Cervical cancer screening ,Papillomaviridae ,Africa South of the Sahara ,RC254-282 ,Pain Measurement ,Cervical cancer ,Sub-Saharan Africa ,business.industry ,Research ,Papillomavirus Infections ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Middle Aged ,medicine.disease ,Logistic Models ,Treatment Outcome ,Oncology ,Patient Satisfaction ,Adverse events ,Catheter Ablation ,Female ,business ,Precancerous Conditions - Abstract
Background The World Health Organization recommends thermal ablation as an alternative to cryotherapy to treat women with precancerous lesions in low-resource settings. However, limited data are available on women’s experience and adverse events (AEs) of the procedure in the context of Sub-Saharan Africa. The objective of this study was to evaluate the acceptability and safety of thermal ablation in women screened positive for precancerous cervical lesions. Methods Asymptomatic women aged 30–49 years old living in the Dschang Health District were invited to participate in a cervical cancer screening campaign termed “3 T-Approach” (for Test-Triage and Treat). Recruited women were asked to perform HPV self-sampling followed by triage with visual assessment and treatment with thermal ablation if required. After treatment and 4–6 weeks later, interviews were conducted to assess women’s experience on anxiety, discomfort, and pain during thermal ablation. AEs were recorded on pre-defined electronic forms 4–6 weeks after treatment to assess the procedure’s safety. Results Between September 2018 and December 2020, 399 HPV-positive women (18.7% of women screened) were recruited, 236 (59.1%) had a positive visual assessment, 234 were treated by thermal ablation and 198 (84.6%) received therapy in the same visit. Treatment was not considered as painful (score ≤ 4/10) by 209 (90.9%) patients while 5 (2.5%) reported high pain (score 8–10/10). During post-treatment interviews 4–6 weeks later, most reported AEs were graded mild or moderate (grade I-II). The most frequent symptoms reported as mild AEs (grade 1–2) were vaginal watery discharge (75.5%), vaginal bloody-stained discharge (21.5%) and malodourous discharge (14.5%). None of the participants experienced serious AEs (grade 3–4) or AEs requiring admission to hospital or emergency consultation. The vast majority of women (99.6%) would agree to repeat the procedure if necessary and (99.6%) would recommend it to friends or family. Conclusion Thermal ablation is widely accepted by women and appears as a safe procedure. It may contribute to improving the link between screening and treatment in a single visit and to optimizing cervical cancer control in low-resource settings. Trial registration The study was registered on clinicaltrials.gov (NCT03757299) in November 2018 (28/11/2018).
- Published
- 2021
81. Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon
- Author
-
Marie-Anne Pham, Khadidja Benkortbi, Bruno Kenfack, Eveline Tincho Foguem, Jessica Sormani, Ania Wisniak, Sophie Lemoupa Makajio, Engelbert Manga, Pierre Vassilakos, and Patrick Petignat
- Subjects
Community Health Workers ,Male ,Papillomavirus Infections ,Public Health, Environmental and Occupational Health ,Humans ,Mass Screening ,Uterine Cervical Neoplasms ,Female ,Cameroon ,Early Detection of Cancer - Abstract
Objectives The World Health Organization’s (WHO) global strategy for cervical cancer elimination has set the target of 70% of women screened in all countries by 2030. Community sensitization through media is often used, but community health workers’ (CHW) involvement may contribute to improving screening coverage. We aimed to assess effectiveness and costs of two cervical cancer screening recruitment strategies conducted in a low-resource setting. Methods The study was conducted in the West Region of Cameroon, in the Health District of Dschang, a community of 300,000 inhabitants. From September 2018 to February 2020, we recruited and screened women for cervical cancer in a single-visit prevention campaign at Dschang District Hospital. During the first 9 months, recruitment was only based on Community Information Channels (CIC) (e.g.. street banners). From the tenth month, participation of CHW was added in the community after training for cervical cancer prevention counselling. Population recruitment was compared between the two strategies by assessing the number of recruited women and direct costs (CHW costs included recruitment, teaching, certification, identification badge, flyers, transport, and incentives). The intervention’s cost-effectiveness was expressed using an incremental cost-effectiveness ratio (ICER). Results and discussion During the period under study, 1940 women were recruited, HPV positive rate was 18.6% (n = 361) and 39 cases of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were diagnosed. Among included participants, 69.9% (n = 1356) of women were recruited through CIC as compared to 30.1% (n = 584) by CHW. The cost per screened woman and CIN2+ diagnosed was higher in the CHW group. The ICER was 6.45 USD or 16.612021Int’l$ per screened woman recruited by CHW. Recruitment in rural areas increased from 12.1 to 61.4% of all women included between CIC-led and CHW-led interventions. These outcomes highlight the importance of training, preparing, and deploying CHW to screen hard-to-reach women, considering that up to 45% of Cameroon’s population lives in rural areas. Conclusion CHW offer an important complement to CIC for expanding coverage in a sub-Saharan African region such as the West Region of Cameroon. CHW play a central role in building awareness and motivation for cervical cancer screening in rural settings.
- Published
- 2021
82. Recruitment strategies to promote uptake of cervical cancer screening in West Cameroon
- Author
-
Patrick Petignat, Evelyn Tincho, Pierre Vassilakos, Marie-Anne Pham, Ania Wisniak, Jessica Sormani, Sophie Lemoupa, Engelbert Manga, Bruno Kenfack, and Khadidja Benkortbi
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cervical cancer screening ,business - Abstract
Objectives World Health Organization’s (WHO) global strategy for cervical cancer elimination has set for 2030 that all countries reach the target of 70% coverage screening rate. Communities’ sensitization through media is often used but community health workers’ (CHW) involvement may contribute to improve screening coverage. We aimed to assess effectiveness and costs of two cervical cancer screening recruitment strategies conducted in a low resource setting. Methods The study was conducted in West region of Cameroon precisely in Dschang Health District, a community of 300’000 people. From September 2018 to February 2020, we recruited and screened women in a cervical cancer single-visit prevention campaign at Dschang District Hospital. For the first nine months, recruitment was only based on Community Information Channels (CIC) (i.e. street banners). Since the tenth month, participation of CHW was added for recruitment in the community after training for cervical cancer counselling. Population recruitment was compared between the two strategies by assessing the number of recruited women, and direct costs (CHW costs include recruitment, teaching, certification, identification badge, flyers, transport, and salary). Interventions’ cost-effectiveness is expressed using an incremental cost-effectiveness ratio (ICER). Results and discussion During the period under study, 1940 women were recruited, HPV positive rate was 18.6% (n = 361) and 39 cervical intraepithelial neoplasia grade 2 or worse (CIN2+) (10,8% of HPV-positive women) were diagnosed. Among participants, 69.9% (n = 1356) of women were recruited through CIC as compared to 30.1% (n = 584) by CHW. The cost per screened woman and CIN2 + diagnosed was higher in the CHW group as compared to the CIC group. The ICER was 6.45 USD or 16.61 2021Int’l$ per screened woman recruited by CHW. In rural areas, recruitment increased from 12.1–61.4% between CIC-led and CHW-led intervention. These outcomes highlight the importance of training, preparing, and deploying CHWs to screen hard-to-reach women, considering that up to 45% of the Cameroon population lives in a rural area. Conclusion CHW offer an important complement to CIC for expanding coverage in a rural sub-Saharan Africa setting like West Cameroon. CHW have a central role in building awareness and motivation for improving cervical cancer screening participation.
- Published
- 2021
83. Vaginal Teratoma: A Fistulized or Parasitic Recurrent Ovarian Teratoma? A Case Report
- Author
-
Jean-Christophe Tille, Jean Dubuisson, Anastasia Kalovidouri, Margherita Pace, Patrick Petignat, and Ana Ghinescu
- Subjects
Ovarian Neoplasms ,Gynecology ,medicine.medical_specialty ,ddc:618 ,Vaginal Neoplasms ,business.industry ,Teratoma ,Obstetrics and Gynecology ,ddc:616.07 ,medicine.disease ,ddc:616.0757 ,Vaginal Teratoma ,Vagina ,Humans ,Medicine ,Female ,Ovarian Teratoma ,business - Published
- 2019
84. HPV self-sampling in the follow-up of women after treatment of cervical intra-epithelial neoplasia: A prospective study in a high-income country
- Author
-
Shahzia Lambat Emery, Lorraine Grangier, Manuela Undurraga Malinverno, Manuela Viviano, Patrick Petignat, Ulrike Meyer-Hamme, and Pierre Vassilakos
- Subjects
medicine.medical_specialty ,Health Informatics ,Cervical intraepithelial neoplasia ,Cohen's kappa ,Interquartile range ,Income country ,Medicine ,Prospective cohort study ,GeneXpert MTB/RIF ,LLETZ ,business.industry ,Obstetrics ,Public Health, Environmental and Occupational Health ,virus diseases ,Regular Article ,medicine.disease ,female genital diseases and pregnancy complications ,Sample size determination ,Cervical cancer ,Screening ,business ,After treatment ,HPV self-sampling - Abstract
Highlights • Self-HPV has a comparable performance to Dr-HPV for HPV detection. • Self-HPV overcomes the need for a gynecological examination at follow-up after LLETZ. • The delay between Self-HPV specimen collection and analysis may alter the test results., Current follow-up strategy for women after large loop excision of the transformation zone (LLETZ) for cervical intra-epithelial neoplasia (CIN) is burdened by a low compliance. We evaluated the performance of home-based Human Papillomavirus (HPV) self-sampling (Self-HPV) after treatment for CIN with the aim to assess the (i) feasibility and (ii) follow-up compliance. This study took place at the Geneva University Hospitals between May 2016 and September 2020. Women aged 18 years or older, undergoing LLETZ for a biopsy-proven cervical intraepithelial neoplasia grade 1 or worse (CIN1 + ) were invited to participate. Agreement statistics, interpreted according to the scale of κ values, were calculated for Self-HPV and HPV performed by the physician (Dr-HPV). The samples were analyzed using GeneXpert and Cobas. Sample size was calculated to provide a 10% precision to estimate the kappa coefficient. A total of 127 women were included, with a median age of 35 years (interquartile range 30–41 years). There was a substantial agreement between Self-HPV and Dr-HPV using GeneXpert at 6 and 12 months, with a κ value of 0.63 (95%CI: 0.47–0.79) and 0.66 (95%CI: 0.50–0.82), respectively. Up to 9/10 (90%) women who did not come to their follow-up visit did not send their Self-HPV, either. In the follow-up after LLETZ treatment, home-based self-HPV is feasible, with substantial agreement between the two groups, however, concern remains regarding adherence to Self-HPV performance at home and loss to follow-up. The trial was registered on clinicaltrials.gov with the identifier NCT02780960.
- Published
- 2021
85. Using Dynamic Features for Automatic Cervical Precancer Detection
- Author
-
Jean-Philippe Thiran, Manuela Undurraga, Pierre Vassilakos, Patrick Petignat, Mohammad Saeed Rad, and Roser Viñals
- Subjects
Cervical cancer ,Medicine (General) ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,visual inspection with acetic acid ,business.industry ,cervical cancer ,screening ,Clinical Biochemistry ,Cervical precancer ,Cervical cancer screening ,medicine.disease ,automatic detection ,Article ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,medicine ,Intensive care medicine ,business ,Cervix ,Primary screening - Abstract
Cervical cancer remains a major public health concern in developing countries due to financial and human resource constraints. Visual inspection with acetic acid (VIA) of the cervix was widely promoted and routinely used as a low-cost primary screening test in low- and middle-income countries. It can be performed by a variety of health workers and the result is immediate. VIA provides a transient whitening effect which appears and disappears differently in precancerous and cancerous lesions, as compared to benign conditions. Colposcopes are often used during VIA to magnify the view of the cervix and allow clinicians to visually assess it. However, this assessment is generally subjective and unreliable even for experienced clinicians. Computer-aided techniques may improve the accuracy of VIA diagnosis and be an important determinant in the promotion of cervical cancer screening. This work proposes a smartphone-based solution that automatically detects cervical precancer from the dynamic features extracted from videos taken during VIA. The proposed solution achieves a sensitivity and specificity of 0.9 and 0.87 respectively, and could be a solution for screening in countries that suffer from the lack of expensive tools such as colposcopes and well-trained clinicians.
- Published
- 2021
86. Gestational trophoblastic disease in Switzerland: retrospective study of the impact of a regional reference centre
- Author
-
Ariane Paoloni-Giacobino, Khadidja Benkortbi, Frédérique Sloan-Béna, Diomidis Botsikas, Anne-Laure Rougemont, Aurore Fehlmann, Ginette Rosseel, Manuela Undurraga Malinverno, Ulrike Meyer-Hamme, Jean-Christophe Tille, Patrice Mathevet, Alexandre Bodmer, and Patrick Petignat
- Subjects
medicine.medical_specialty ,Gestational Trophoblastic Neoplasms ,medicine.medical_treatment ,Disease ,ddc:616.07 ,Chorionic Gonadotropin ,ddc:616.0757 ,Human chorionic gonadotropin ,Pregnancy ,medicine ,Humans ,ddc:576.5 ,Gestational Trophoblastic Disease ,reproductive and urinary physiology ,Partial Hydatidiform Mole ,Retrospective Studies ,Chemotherapy ,ddc:618 ,Gestational trophoblastic disease ,business.industry ,Obstetrics ,Retrospective cohort study ,General Medicine ,Hydatidiform Mole ,medicine.disease ,female genital diseases and pregnancy complications ,embryonic structures ,Methotrexate ,Female ,business ,Switzerland ,medicine.drug - Abstract
AIMS OF THE STUDY The European Society of Medical Oncology (ESMO) recommends that countries should have reference centres to provide adequate diagnosis and treatment of gestational trophoblastic disease. A trophoblastic disease centre in the French-speaking part of Switzerland was inaugurated in 2009. The objectives of this study were to report the activity of the centre during the last 10 years and analyse gestational trophoblastic disease outcomes. METHODS This was a retrospective study with data collected from all cases of gestational trophoblastic disease referred to the centre from 2009 to 2018. All histological specimens as well as data for treatment and follow-up of gestational trophoblastic disease and neoplasia were reviewed. Clinical features, including age, prognostic score and International Federation of Gynecology and Obstetrics (FIGO) stages (in the case of gestational trophoblastic neoplasia), human chorionic gonadotropin (hCG) follow-up, treatment and outcome were reported. RESULTS The centre registered 354 patients, and these patients presented 156 cases of partial hydatidiform moles, 163 cases of complete hydatidiform moles and 14 cases of gestational trophoblastic neoplasia. During follow-up, 35 gestational trophoblastic neoplasms were diagnosed after hCG persistence. After pathology review, the overall agreement rates between our centre and a participating provider hospital was 82%. Methotrexate was the first line of single-agent chemotherapy for most patients, with resistance rates of 23%. Multi-agent chemotherapy was used as first-line treatment for five patients. None of the patients followed up by the centre died from gestational trophoblastic disease. CONCLUSIONS This study reflects the activity of the Swiss trophoblastic disease centre from the French-speaking part of Switzerland created in 2009, and its role as local and national reference centre, in terms of global health, for women with gestational trophoblastic disease.
- Published
- 2021
87. Spontaneous Intussusception Treated by a Conservative Laparoscopic Approach during Pregnancy
- Author
-
Nadja Benmohamed, Patrick Petignat, Jean Dubuisson, and Frédéric Ris
- Subjects
medicine.medical_specialty ,Pregnancy ,ddc:618 ,ddc:617 ,business.industry ,General surgery ,Intussusception (medical disorder) ,medicine ,Obstetrics and Gynecology ,medicine.disease ,business - Published
- 2020
88. ABCD criteria to improve visual inspection with acetic acid (VIA) triage in HPV-positive women: a prospective study of diagnostic accuracy
- Author
-
Patrick Petignat, Bruno Kenfack, Ania Wisniak, Essia Saiji, Jean-Christophe Tille, Jovanny Tsuala Fouogue, Rosa Catarino, Eveline Tincho, and Pierre Vassilakos
- Subjects
Adult ,Papillomavirus Infections ,Humans ,Uterine Cervical Neoplasms ,Female ,Prospective Studies ,General Medicine ,Middle Aged ,Triage ,Early Detection of Cancer ,Acetic Acid - Abstract
ObjectivesA simple system for visual inspection with acetic acid assessment, named ABCD criteria, has been developed to increase accuracy for triaging of high-risk human papillomavirus (HPV)-positive women. This study aimed to determine the accuracy of ABCD criteria for the detection of histologically confirmed cervical intraepithelial neoplasia grade two or worse (CIN2+) in HPV-positive women living in a low-resource setting.DesignProspective study of diagnostic accuracy.SettingCervical cancer screening programme based on a 3T-Approach (test, triage and treat) in the Health District of Dschang, West Cameroon.ParticipantsAsymptomatic non-pregnant women aged 30–49 years were eligible to participate. Exclusion criteria included history of CIN treatment, anogenital cancer or hysterectomy. A total of 1980 women were recruited (median age, 40 years; IQR 35–45 years), of whom 361 (18.4%) were HPV-positive and 340 (94.2%) completed the trial.InterventionsHPV-positive women underwent a pelvic examination for visual assessment of the cervix according to ABCD criteria. The criteria comprised A for acetowhiteness, B for bleeding, C for colouring and D for diameter. The ABCD criteria results were codified as positive or negative and compared with histological analysis findings (reference standards).Primary outcome measureDiagnostic performance of ABCD criteria for CIN2+, defined as sensitivity, specificity, negative and positive predictive values.ResultsABCD criteria had a sensitivity of 77.5% (95% CI 61.3% to 88.2%), specificity of 42.0% (95% CI 36.5% to 47.7%), positive predictive value of 15.1% (95% CI 10.8% to 20.8%), and negative predictive value of 93.3% (95% CI 87.6% to 96.5%) for detection of CIN2 +lesions. Most (86.7%) of the ABCD-positive women were treated on the same day.ConclusionsABCD criteria can be used in the context of a single-visit approach and may be the preferred triage method for management of HPV-positive women in a low-income context.Trial registration numberNCT03757299.
- Published
- 2022
89. 8 Operative Techniken: Was ist möglich?
- Author
-
Roland Scherer, Thilo Schwalenberg, Kees Waaldijk, Babbar Ruga, Jasmine Abdulcadir, Sandra Marras, Nicole Schmidt, Lucrezia Catania, Omar Abdulcadir, Patrick Petignat, Uwe von Fritschen, Jürgen Wacker, Comfort Momoh, and Martina Kruse
- Published
- 2020
90. Correction to: Clitoral leiomyoma in a premenopausal woman: a case report
- Author
-
Diego Aguiar, Jean-Christophe Tille, Jasmine Abdulcadir, Gianmarco Taraschi, and Patrick Petignat
- Subjects
Adult ,Male ,medicine.medical_specialty ,Leiomyoma ,business.industry ,Maternal and child health ,Obstetrics ,lcsh:Public aspects of medicine ,Reproductive medicine ,MEDLINE ,Obstetrics and Gynecology ,Correction ,lcsh:RA1-1270 ,General Medicine ,medicine.disease ,lcsh:Gynecology and obstetrics ,Clitoris ,Reproductive Medicine ,medicine ,Humans ,Female ,Bartholin's Glands ,business ,lcsh:RG1-991 - Abstract
Extrauterine leiomyomata is an uncommon lesion that can lead to several problems of differential diagnosis, especially when localized in the external genitalia. There are few reports in the English literature and a novel association with Alport's syndrome has been investigated since the 1980s.Here, we describe the case of a premenopausal woman who presented with an indolent swelling of the right interlabial fossa that resulted in a Bartholin cyst. In addition to this cyst, a benign leiomyoma of the right side of the clitoris was also found and removed. Our patient refused any further examination, although she was informed that genetic counselling could be organized to rule out an association with Alport's syndrome.Extrauterine leiomyomata localized in the external genitalia is an uncommon lesion arising from smooth muscle cells around vascular epithelium or erectile tissue. Since an association between extrauterine leiomyomata and Alport's syndrome has been described, genetic testing can be proposed to these patients. Upper intestinal tract symptoms such as dysphagia should prompt a gastroenterological evaluation as an association with an esophageal leiomyomatosis has been described.
- Published
- 2020
91. Test HPV pour le dépistage du cancer du col utérin: La réticence des cytopathologistes suisses aux nouvelles recommandations est-elle justifiée?
- Author
-
Patrick Petignat, Christian Polli, Brigitte Frey Tirri, Martine Jacot-Guillarmod, Pierre Vassilakos, and André B. Kind
- Published
- 2020
92. Case Study: Schistosomiasis of the Endocervical Canal, A Rarely Reported Localization
- Author
-
Manuela Viviano, Martine Delavy, Pierre Vassilakos, Josea Lea Heriniainasolo, Patrick Petignat, and Rosa Catarino
- Subjects
0301 basic medicine ,Female circumcision ,Adult ,medicine.medical_specialty ,Pathology ,Disease detection ,Endocervical canal ,Schistosomiasis ,Cervix Uteri ,Cervical cancer screening ,Asymptomatic ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Schistosoma ,biology ,Obstetrics ,business.industry ,Public health ,Obstetrics and Gynecology ,biology.organism_classification ,medicine.disease ,030104 developmental biology ,030220 oncology & carcinogenesis ,Female ,medicine.symptom ,business - Abstract
With a challenging diagnosis, schistosomiasis is a major public health issue worldwide, particularly in low-resource countries. The presence of Schistosoma ova in the female genital tract is a common finding, which may engender considerable suffering among women of child-bearing age. We report the asymptomatic case of endocervical schistosomiasis without visible exocervical lesions in a 41-yr-old Malagasy woman with human papillomavirus-positive status detected during a cervical cancer screening campaign in Andilampanahy, Madagascar. Schistosomiasis involving only the endocervical canal is rarely reported and can be diagnosed histologically with endocervical brushing, which therefore represents a minimally invasive and well-tolerated tool for disease detection.
- Published
- 2020
93. Is thermal ablation a new standard for cervical pre-cancer treatment in low-income and middle-income countries?
- Author
-
Bruno Kenfack and Patrick Petignat
- Subjects
ddc:618 ,business.industry ,medicine.medical_treatment ,Thermal ablation ,MEDLINE ,Developing country ,Uterine Cervical Neoplasms ,Cryotherapy ,Low income and middle income countries ,Acetates ,Cancer treatment ,Oncology ,Environmental health ,medicine ,Income ,Humans ,Female ,business ,Developing Countries - Published
- 2020
94. Médecine hautement spécialisée et gynécologie
- Author
-
Patrice Mathevet, Patrick Petignat, and Begoña Martinez De Tejada
- Subjects
General Medicine - Published
- 2022
95. Self- versus physician-collected samples for the follow-up of human papillomavirus-positive women in sub-Saharan Africa
- Author
-
Eveline Tincho Foguem, Manuela Viviano, Pierre Vassilakos, Liliane Temogne, Patrick Petignat, Rosa Catarino, Bruno Kenfack, Phuong Lien Tran, and Mohamed Akaaboune
- Subjects
Human Papillomavirus Positive ,medicine.medical_specialty ,Sub saharan ,cervical cancer ,International Journal of Women's Health ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Cytology ,District hospital ,Maternity and Midwifery ,medicine ,follow-up ,Sampling (medicine) ,Original Research ,Cervical cancer ,030219 obstetrics & reproductive medicine ,ddc:618 ,business.industry ,Obstetrics ,screening ,Obstetrics and Gynecology ,virus diseases ,self-sampling ,medicine.disease ,female genital diseases and pregnancy complications ,Squamous intraepithelial lesion ,Oncology ,030220 oncology & carcinogenesis ,business ,human papillomavirus testing - Abstract
Manuela Viviano,1,* Phuong Lien Tran,1,* Bruno Kenfack,2 Rosa Catarino,1 Mohamed Akaaboune,1,† Liliane Temogne,2 Eveline Tincho Foguem,2 Pierre Vassilakos,3 Patrick Petignat1 1Gynecology Division, Geneva University Hospitals, Geneva, Switzerland; 2Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon; 3Geneva Foundation for Medical Education and Research, Geneva, Switzerland *These authors contributed equally to the work †MA passed away on July 31, 2017 Introduction: Human papillomavirus (HPV) testing is a suitable tool for primary cervical cancer (CC) screening and follow-up in low-resource settings. Vaginal samples taken by women themselves (Self-HPV) are an interesting alternative to physician-performed sampling (Dr-HPV). Our aim was to assess the performance of Self-HPV and Dr-HPV at 6 and 12months following a CC screening campaign. Methods: This study was carried out at the Dschang District Hospital, Cameroon. Women aged 30–49years were recruited in a CC screening campaign. HPV-positive women, of whom 2/3 were treated with thermoablation because of abnormal results at baseline screening, were invited to participate in a follow-up study. Self- and Dr-HPV, as well as cytology, were performed at 6 and 12months. HPV samples were analyzed using the Xpert HPV assay. Sensitivity and specificity for the detection of low-grade squamous intraepithelial lesion or worse and of high-grade squamous intraepithelial lesion or worse were calculated for Self-HPV and Dr-HPV, using cytology as the reference diagnosis. Results: Overall, 188 HPV-positive women were invited to attend follow-up. The obtained follow-up visits’ attendance was 154 (81.9%) and 131 (69.7%) at 6 and 12months, respectively. While the overall performance of Dr-HPV at 6months was slightly superior, Self-HPV showed an improved sensitivity for HSIL+ detection at 12months when compared with Dr-HPV (83.3% [95% CI 41.8–98.9] versus 71.4% [95% CI 21.5–95.8], respectively). The overall HPV positivity agreement between Self- and Dr-HPV at 6 and 12months corresponded to a κ value of 0.62 and 0.52, respectively. Among women treated with thermoablation (n=121) at baseline screening, Self-HPV was as sensitive as Dr-HPV, although less specific (P=0.003). Conclusion: Self-HPV is a valuable tool for the follow-up of HPV-positive women in low-resource settings. Larger, randomized trials are needed to confirm the validity of our findings. Keywords: human papillomavirus testing, self-sampling, cervical cancer, screening, follow-up
- Published
- 2018
96. A Mobile Health Data Collection System for Remote Areas to Monitor Women Participating in a Cervical Cancer Screening Campaign
- Author
-
Jeromine Jinoro, Manuela Viviano, Kelly Quercia, Patrick Petignat, Joséa Lea Herniainasolo, Pierre Vassilakos, Phuong Lien Tran, and Caroline Benski
- Subjects
Adult ,medicine.medical_specialty ,Telemedicine ,business.product_category ,020205 medical informatics ,Uterine Cervical Neoplasms ,Health Informatics ,02 engineering and technology ,Low-resource settings ,Cervical cancer screening ,Collection system ,Health data ,03 medical and health sciences ,0302 clinical medicine ,Health Information Management ,Madagascar ,Photography ,0202 electrical engineering, electronic engineering, information engineering ,Internet access ,Humans ,Medicine ,Central database ,Early Detection of Cancer ,Aged ,Data collection system ,Gynecology ,ddc:618 ,business.industry ,Data Collection ,Papillomavirus Infections ,General Medicine ,Middle Aged ,medicine.disease ,Mobile Applications ,030220 oncology & carcinogenesis ,M-Health ,Female ,Medical emergency ,business ,Healthcare providers ,Patient record - Abstract
Barriers to efficient cervical cancer screening in low- and medium-income countries include the lack of systematic monitoring of the participants' data. The aim of this study was to assess the feasibility of a mobile health (m-Health) data collection system to facilitate monitoring of women participating to cervical cancer screening campaign.Women aged 30-65 years, participating in a cervical cancer screening campaign in Ambanja, Madagascar, were invited to participate in the study. Cervical Cancer Prevention System, an m-Health application, allows the registration of clinical data, while women are undergoing cervical cancer screening. All data registered in the smartphone were transmitted onto a secure, Web-based platform through the use of an Internet connection. Healthcare providers had access to the central database and could use it for the follow-up visits. Quality of data was assessed by computing the percentage of key data missing.A total of 151 women were recruited in the study. Mean age of participants was 41.8 years. The percentage of missing data for the key variables was less than 0.02%, corresponding to one woman's medical history data, which was not sent to the central database. Technical problems, including transmission of photos, human papillomavirus test results, and pelvic examination data, have subsequently been solved through a system update.The quality of the data was satisfactory and allowed monitoring of cervical cancer screening data of participants. Larger studies evaluating the efficacy of the system for the women's follow-up are needed in order to confirm its efficiency on a long-term scale.
- Published
- 2018
97. PERFORMANCE OF SMARTPHONE-BASED DIGITAL IMAGES FOR CERVICAL CANCER SCREENING IN A LOW-RESOURCE CONTEXT
- Author
-
Pierre Vassilakos, Phuong Lien Tran, Josea Lea Herinianasolo, Caroline Benski, Christophe Combescure, Jeromine Jinoro, Manuela Viviano, and Patrick Petignat
- Subjects
Adult ,medicine.medical_specialty ,Uterine Cervical Neoplasms ,Antinuclear/blood ,Context (language use) ,Cervical cancer screening ,Sensitivity and Specificity ,Antibodies ,03 medical and health sciences ,Digital image ,0302 clinical medicine ,80 and over ,Neutrophils/immunology/pathology ,Madagascar ,medicine ,Humans ,Medical physics ,030212 general & internal medicine ,Pleural Effusion/diagnosis/etiology/immunology/pathology ,Early Detection of Cancer ,Aged ,Cervical cancer ,ddc:618 ,Systemic/complications/diagnosis/immunology/pathology ,Lupus Erythematosus ,business.industry ,Health Policy ,Papillomavirus Infections ,Online database ,Gold standard (test) ,Uterine Cervical Dysplasia ,medicine.disease ,Confidence interval ,Visual inspection ,Pulmonary Eosinophilia/diagnosis/etiology/immunology/pathology ,030220 oncology & carcinogenesis ,Female ,Smartphone ,Neoplasm Grading ,Autoantibodies/blood ,business - Abstract
Objectives:Colposcopes are expensive, heavy, and need specialized technical service, which may outreach the capacity of low-resource settings. Our aim was to assess the performance of smartphone-based digital images for the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+).Methods:Human papillomavirus (HPV)-positive women recruited through a cervical cancer screening campaign had VIA/VILI assessment (visual inspection after application of acetic acid/lugol's iodine). Cervical digital images were captured with a smartphone camera, randomly coded with no prior selection and distributed on an online database (Google Forms) for evaluation. Healthcare providers were invited to evaluate the images and identify CIN2+. The gold standard was the histopathological diagnosis. The sensitivity and specificity for the detection of CIN2+ was assessed for each reader and reported with the 95 percent confidence interval (Clopper-Pearson method).Results:One hundred twenty-five consecutive HPV-positive women were included, with 19 CIN2+ (15.2 percent). Forty-five gynecologists completed the assessment, one-third were considered as experts (>50 colposcopies) and two-thirds as novices (Conclusion:Smartphone-based digital images, with its high portability, have a great potential for the diagnosis of CIN2+ in low-resource context.
- Published
- 2018
98. Efficacy of thermoablation in treating cervical precancerous lesions in a low-resource setting
- Author
-
Manuela Viviano, Eveline Tincho Foguem, Patrick Petignat, Pierre-Marie Tebeu, Anne-Caroline Benski, Rosa Catarino, Phuong Lien Tran, Pierre Vassilakos, Liliane Temogne, and Bruno Kenfack
- Subjects
HPV testing ,medicine.medical_specialty ,cervical cancer ,medicine.medical_treatment ,International Journal of Women's Health ,Cryotherapy ,Endocervical curettage ,Cervical intraepithelial neoplasia ,thermoablation ,03 medical and health sciences ,0302 clinical medicine ,Maternity and Midwifery ,Medicine ,Risk factor ,Original Research ,Cervical cancer ,ddc:618 ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,self-sampling ,Obstetrics and Gynecology ,Odds ratio ,medicine.disease ,Occult ,female genital diseases and pregnancy complications ,Confidence interval ,Oncology ,030220 oncology & carcinogenesis ,business - Abstract
Phuong Lien Tran,1 Bruno Kenfack,2 Eveline Tincho Foguem,3 Manuela Viviano,1 Liliane Temogne,2 Pierre-Marie Tebeu,4 Rosa Catarino,1 Anne-Caroline Benski,1 Pierre Vassilakos,5 Patrick Petignat1 1Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland; 2Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon; 3Department of Gynecology and Obstetrics, District Hospital of Biyem-Assi, Yaoundé, Cameroon; 4Department of Gynecology and Obstetrics, University Centre Hospital, Yaoundé, Cameroon; 5Geneva Foundation for Medical Education and Research, Geneva, Switzerland Introduction: Treating cervical intraepithelial neoplasia (CIN) grades 2 and 3 is the recommended strategy for preventing invasive carcinoma in low- and middle-income countries (LMICs). Our objective was to assess the efficacy of thermoablation in the treatment of CIN2 and CIN3 in a screen-and-treat approach.Methods: Women aged 30–49 years in Dschang, Cameroon, were invited to undergo vaginal sampling for human papillomavirus (HPV), samples being assessed by an Xpert HPV Assay. HPV-positive women underwent visual inspection with acetic acid (VIA) and visual inspection with Lugol’s iodine (VILI), cervical biopsy, and endocervical curettage. Women positive for HPV-16/18/45 or other HPV types with abnormal VIA/VILI were treated by thermoablation on the same day. The primary outcome was persistence of high-grade disease on cytologic examination at 12 months.Results: Of a total of 1,012 recruited women, 188 were HPV-positive, 121 patients required thermoablation, and 99 had a CIN of grade
- Published
- 2017
99. Sexual, psychological, interpersonal well-being and (unmet) supportive care needs of couples after a gynecological cancer treatment
- Author
-
Pernelle, Dalex, primary, Kaneez, Koheeallee, primary, Manuela, Undurraga Malinverno, primary, Patrick, Petignat, primary, and Leen, Aerts, primary
- Published
- 2021
- Full Text
- View/download PDF
100. Effects of the COVID-19 pandemic on an urban cervical cancer screening program in West Cameroon
- Author
-
Jessica Sormani, Alida Moukam Datchoua, Patrick Petignat, Nicole Schmidt, and Bruno Kenfack
- Subjects
2019-20 coronavirus outbreak ,Urban Population ,Coronavirus disease 2019 (COVID-19) ,cervical cancer ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Uterine Cervical Neoplasms ,Corners of the World ,Cervical cancer screening ,cervix uteri ,Environmental health ,Pandemic ,medicine ,Humans ,Cameroon ,Pandemics ,Early Detection of Cancer ,Cervical cancer ,business.industry ,COVID-19 ,Obstetrics and Gynecology ,Cancer ,medicine.disease ,Oncology ,Low and middle income countries ,Female ,business - Abstract
Cervical cancer is the fourth most common cancer among women worldwide, and in 2020 almost 85% of new cases occurred in low and middle income countries. In Cameroon, 1787 deaths were recorded in 2020, making cervical cancer the second most common cause of cancer deaths among women. Recently, in 2020
- Published
- 2021
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.