HPV detection in a self-collected vaginal swab combined with VIA for cervical cancer screening with correlation to histologically confirmed CIN.

AIM: To first compare the accuracy of self-, Physician-HPV testing and VIA as standalone screening tests; and second to compare the accuracy of Self-HPV positive test triaged with VIA with the different standalone screening tests as colposcopy and histologically confirmed CIN for cervical cancer screening in low-resource settings METHODS: 1,601 women in Sharkya Governerate, Egypt concurrently received HPV DNA testing [Hybrid Capture 2 (HC2) assay] for self-collected and physician-obtained samples, and VIA. Women who tested positive for HPV DNA or VIA received colposcopy and biopsy. RESULTS: Percentage of women testing positive was 84.8 % on Self-HPV, 87.8 % on Physician-HPV, and 76.8 % on VIA. Test positivity increased in all screening methods with increasing severity of histopathologic diagnosis. Physician-HPV and HPV testing on a self-sample showed a very good agreement for HPV testing results [κ = 0.89 (95 % CI = 0.52-0.79)]; no statistically significant variation between age groups in the sensitivities of HPV testing on a self-sample, Physician-HPV testing for detecting CIN2 or CIN3 lesions. Conversely, VIA sensitivity was lower in detecting CIN2 and CIN3 than HPV testing on a self-sample and decreased significantly in the older age groups. HPV testing on a self-sample positive combined with VIA increases specificity to 98.1 % for CIN2 and 99.4 % for CIN3, and decreased colposcopy referral rate to 2.5 %. CONCLUSION: HPV testing on a self-sample is more accurate than VIA and as accurate as clinician-HPV testing for cervical cancer in low-resource settings.

Is genetic polymorphism of ER-α, CYP1A1, and CYP1B1 a risk factor for uterine leiomyoma?

INTRODUCTION: Uterine leiomyoma is the most common benign smooth muscle tumor. OBJECTIVE: This study was carried out to evaluate the association of ER-α, CYP1A1, and CYP1B1 polymorphisms with uterine leiomyoma in Egyptian women. METHODS: The study population consisted of 160 patients with uterine leiomyoma and 100 healthy women as control. The genetic polymorphisms for ER-α MSP1 exon 1, CYP1B1 Leu432Val, and CYP1A1 Ile462Val were analyzed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing methods. RESULTS: There were no statistically significant differences in the overall associations between the ER-α exon I CT genotypes and uterine leiomyoma (P = 0.47). However, an elevated risk of uterine leiomyoma was observed among women with the CYP1A1 Ile462Val AG genotype (P = 0.07) and CYP1B1 Leu 432Val C/C genotype (P = 0.08). CONCLUSION: We concluded that the carriage of CYP1A1 Ile462Val AG and CYP1B1 Leu 432Val CC genotypes predict the susceptibility to leiomyoma in Egyptian women and they are likely to contribute in the pathogenesis of leiomyoma.