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1.
Br J Cancer ; 107(9): 1624-30, 2012 Oct 23.
Article in English | MEDLINE | ID: mdl-23033006

ABSTRACT

BACKGROUND: We assessed the association of human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) with various characteristics, CD4 count and use of combination antiretroviral therapy (cART) among HIV-positive women. METHODS: Cross-sectional study of 498 HIV-positive women who underwent HPV PCR-based testing, cytology, and systematic cervical biopsy. RESULTS: In all, 68.7% of women were HPV-positive, 52.6% had high-risk (hr) HPV, and 40.2% multiple type infections. High-risk human papillomavirus-positivity did not vary significantly by age but it was negatively associated with education level. The most frequent types in 113 CIN2/3 were HPV16 (26.5%), HPV35 (19.5%), and HPV58 (12.4%). CD4 count was negatively associated with prevalence of hrHPV (P<0.001) and CIN2/3 among non-users of cART (P=0.013). Combination antiretroviral therapies users (≥2 year) had lower hrHPV prevalence (prevalence ratio (PR) vs non-users=0.77, 95% confidence interval (CI): 0.61-0.96) and multiple infections (PR=0.68, 95% CI: 0.53-0.88), but not fewer CIN2/3. The positive predictive value of hrHPV-positivity for CIN2/3 increased from 28.9% at age <35 years to 53.3% in ≥45 years. CONCLUSION: The burden of hrHPV and CIN2/3 was high and it was related to immunosuppression level. Combination antiretroviral therapies ( ≥2 year) use had a favourable effect on hrHPV prevalence but cART in our population may have been started too late to prevent CIN2/3.


Subject(s)
HIV Infections/epidemiology , Papillomavirus Infections/epidemiology , Uterine Cervical Dysplasia/epidemiology , Uterine Cervical Neoplasms/epidemiology , Adult , Cohort Studies , Cross-Sectional Studies , Female , HIV Infections/virology , Humans , Kenya/epidemiology , Middle Aged , Papillomavirus Infections/virology , Prevalence , Uterine Cervical Neoplasms/virology , Uterine Cervical Dysplasia/virology
2.
J Radiol Prot ; 22(3A): A137-41, 2002 Sep.
Article in English | MEDLINE | ID: mdl-12400962

ABSTRACT

The current paper presents the methods and design of two case-control studies among Chernobyl liquidators-one of leukaemia and non-Hodgkin lymphoma, the other of thyroid cancer risk-carried out in Belarus, Estonia, Latvia, Lithuania and Russia. The specific objective of these studies is to estimate the radiation induced risk of these diseases among liquidators of the Chernobyl accident, and, in particular, to study the effect of exposure protraction and radiation type on the risk of radiation induced cancer in the low-to-medium- (0-500 mSv) radiation dose range. The study population consists of the approximately 10000 Baltic, 40000 Belarus and 51 000 Russian liquidators who worked in the 30 km zone in 1986-1987, and who were registered in the Chernobyl registry of these countries. The studies included cases diagnosed in 1993-1998 for all countries but Belarus, where the study period was extended until 2000. Four controls were selected in each country from the national cohort for each case, matched on age, gender and region of residence. Information on study subjects was obtained through face-to-face interview using a standardised questionnaire with questions on demographic factors, time, place and conditions of work as a liquidator and potential risk and confounding factors for the tumours of interest. Overall, 136 cases and 595 controls after receiving their consent were included in the studies. A method of analytical dose reconstruction has been developed, validated and applied to the estimation of doses and related uncertainties for all the subjects in the study. Dose-response analyses are underway and results are likely to have important implications to assess the adequacy of existing protection standards, which are based on risk estimates derived from analyses of the mortality of atomic bomb survivors and other high dose studies.


Subject(s)
Neoplasms, Radiation-Induced/etiology , Occupational Diseases/etiology , Power Plants , Radioactive Hazard Release , Baltic States , Case-Control Studies , Decontamination , Humans , Leukemia, Radiation-Induced/etiology , Lymphoma, Non-Hodgkin/etiology , Radiation Dosage , Republic of Belarus , Russia , Thyroid Neoplasms/etiology
3.
Int J Cancer ; 91(3): 421-30, 2001 Feb 01.
Article in English | MEDLINE | ID: mdl-11169969

ABSTRACT

There is growing evidence that excess body weight increases the risk of cancer at several sites, including kidney, endometrium, colon, prostate, gallbladder and breast in post-menopausal women. The proportion of all cancers attributable to overweight has, however, never been systematically estimated. We reviewed the epidemiological literature and quantitatively summarised, by meta-analysis, the relationship between excess weight and the risk of developing cancer at the 6 sites listed above. Estimates were then combined with sex-specific estimates of the prevalence of overweight [body mass index (BMI) 25-29 kg/m(2)] and obesity (BMI > or = 30 kg/m(2)) in each country in the European Union to obtain the proportion of cancers attributable to excess weight. Overall, excess body mass accounts for 5% of all cancers in the European Union, 3% in men and 6% in women, corresponding to 27,000 male and 45,000 female cancer cases yearly. The attributable proportion varied, in men, between 2.1% for Greece and 4.9% for Germany and, in women, between 3.9% for Denmark and 8.8% for Spain. The highest attributable proportions were obtained for cancers of the endometrium (39%), kidney (25% in both sexes) and gallbladder (25% in men and 24% in women). The largest number of attributable cases was for colon cancer (21,500 annual cases), followed by endometrium (14,000 cases) and breast (12,800 cases). Some 36,000 cases could be avoided by halving the prevalence of overweight and obese people in Europe.


Subject(s)
Neoplasms/etiology , Obesity/complications , Body Weight , Breast Neoplasms/epidemiology , Breast Neoplasms/etiology , Breast Neoplasms/prevention & control , Colonic Neoplasms/epidemiology , Colonic Neoplasms/etiology , Colonic Neoplasms/prevention & control , Endometrial Neoplasms/epidemiology , Endometrial Neoplasms/etiology , Endometrial Neoplasms/prevention & control , European Union , Female , Gallbladder Neoplasms/epidemiology , Gallbladder Neoplasms/etiology , Gallbladder Neoplasms/prevention & control , Humans , Kidney Neoplasms/epidemiology , Kidney Neoplasms/etiology , Kidney Neoplasms/prevention & control , Male , Menopause , Neoplasms/epidemiology , Neoplasms/prevention & control , Obesity/epidemiology , Obesity/prevention & control , Prevalence , Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/etiology , Prostatic Neoplasms/prevention & control
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