THE INFLUENCE OF VARIOUS RISK FACTORS ON THE CORRELATION BETWEEN HPV INFECTION AND THE ADVANCEMENT OF CERVICAL CARCINOMA

NT BUKHARI; S JABEEN; U JABEEN; I NISA; UA KHAN; A LIAQAT; S FAROOQ; K ZAMAN; F SHIREEN; M AYAZ

doi:10.54112/bcsrj.v2024i1.942

Authors

NT BUKHARI Department of Medical Laboratory Technology/Microbiology, Multidisciplinary Research Lab Bahria University of Health Sciences Karachi Campus, Pakistan
S JABEEN 2Department of Medical Laboratory Technology, Khyber Medical University, Institute of Health Sciences, Islamabad/Department of Biosciences, COMSATS University, Islamabad, Pakistan
U JABEEN Department of Gynae and Obs, Hayatabad Medical Complex, Peshawar, Pakistan
I NISA Department of Microbiology, Women University Swabi, Pakistan
UA KHAN Hayatabad Medical Complex, Peshawar, Pakistan
A LIAQAT Department of Allied Health Sciences Superior University Sargodha, Pakistan
S FAROOQ Department of Allied health sciences, Sarhad University of Science and Information Technology, Peshawar, Pakistan
K ZAMAN Department of Allied health sciences, Sarhad University of Science and Information Technology, Peshawar, Pakistan
F SHIREEN Department of Allied Health Sciences, Iqra National University, Peshawar Campus, Pakistan
M AYAZ Center of Biotechnology and Microbiology, University of Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.942

Keywords:

Cervical cancer, HPV, Risk factors, Gravidity, Parity, Tobacco use, Rural residence, Early marriage, Case-control study

Abstract

Cervical cancer is a significant global health challenge, disproportionately impacting women in developing nations, where approximately 85% of incidence and mortality occur. The primary etiological agent is the human papillomavirus (HPV), with high-risk types HPV 16 and 18 accounting for over 90% of cases. Despite the high prevalence of HPV, most infected women do not develop cervical cancer, indicating the role of additional risk factors. Objective: This study aims to investigate the association between various sociodemographic and behavioral factors, HPV infection, and the progression of cervical cancer. Methods: This case-control study was conducted at the Cancer Care Hospital and Research Center in Pakistan from April 2024 to April 2024. It involved 200 consecutive subjects, with 100 cases diagnosed with precancerous lesions (HSIL/LSIL) or invasive carcinoma of the uterine cervix, and 100 age and ethnicity-matched controls with normal cervical cytology. Data were collected through structured personal interviews and analyzed using descriptive and inferential statistical methods. The significance level was set at p < 0.05. Results: Significant differences between cases and controls were observed in dietary habits, gravidity, parity, age, menopausal status, residential setup, tobacco chewing, smoking, and age at marriage. Non-vegetarian diet, higher gravidity and parity, older age, postmenopausal status, rural residence, tobacco use, and early marriage were significantly associated with increased cervical cancer risk (p < 0.0001). No significant difference was found in literacy rates (p = 0.68). Conclusion: The study highlights the multifactorial etiology of cervical cancer, emphasizing the need for targeted interventions addressing specific risk factors. Early detection, HPV vaccination, and public health education, particularly in rural areas, are crucial for reducing cervical cancer burden.

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References

Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. The Lancet Global Health. 2020;8(2):e191-e203.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68(6):394-424.

Small Jr W, Bacon MA, Bajaj A, Chuang LT, Fisher BJ, Harkenrider MM, et al. Cervical cancer: a global health crisis. Cancer. 2017;123(13):2404-12.

Schiffman M, Castle PE. The promise of global cervical-cancer prevention. New England Journal of Medicine. 2005;353(20):2101-4.

Crosbie EJ, Einstein MH, Franceschi S, Kitchener HC. Human papillomavirus and cervical cancer. The Lancet. 2013;382(9895):889-99.

Castle P, Maza M. Prophylactic HPV vaccination: past, present, and future. Epidemiology & Infection. 2016;144(3):449-68.

Phillips A, Patel C, Pillsbury A, Brotherton J, Macartney K. Safety of human papillomavirus vaccines: an updated review. Drug safety. 2018;41:329-46.

Zakka AW, Ayolabi CI, Olusola BA. Prevalence of Cervical Human Papillomavirus (HPV) Infection Among Women in Some Areas of North-central Nigeria. Egyptian Academic Journal of Biological Sciences, G Microbiology. 2023;15(2):103-17.

Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. International journal of gynecology & obstetrics. 2018;143:22-36.

Aggarwal N, Yadav J, Thakur K, Bibban R, Chhokar A, Tripathi T, et al. Human papillomavirus infection in head and neck squamous cell carcinomas: transcriptional triggers and changed disease patterns. Frontiers in Cellular and Infection Microbiology. 2020;10:537650.

Doh G, Mkong E, Ikomey GM, Obasa AE, Mesembe M, Fokunang C, et al. Preinvasive cervical lesions and high prevalence of human papilloma virus among pregnant women in Cameroon. Germs. 2021;11(1):78.

Rivera-Soto R, Damania B. Modulation of angiogenic processes by the human gammaherpesviruses, epstein–barr virus and kaposi’s sarcoma-associated herpesvirus. Frontiers in microbiology. 2019;10:1544.

Joura EA, Giuliano AR, Iversen O-E, Bouchard C, Mao C, Mehlsen J, et al. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. New England Journal of Medicine. 2015;372(8):711-23.

Abdalla E, Habtemariam T, Fall S, Troy R, Tameru B, Nganwa D. A comparative study of health disparities in cervical cancer mortality rates through time between black and Caucasian women in Alabama and the US. International journal of studies in nursing. 2021;6(1):9.

Basu P, Malvi SG, Joshi S, Bhatla N, Muwonge R, Lucas E, et al. Vaccine efficacy against persistent human papillomavirus (HPV) 16/18 infection at 10 years after one, two, and three doses of quadrivalent HPV vaccine in girls in India: a multicentre, prospective, cohort study. The Lancet Oncology. 2021;22(11):1518-29.