A new face of the HPV epidemic: Oropharyngeal cancer in the elderly
Authors: Dickstein, Daniel R.; Egerman, Marc A.; Bui, Anthony H.; Doucette, John T.; Sharma, Sonam; Liu, Jerry; Gupta, Vishal; Miles, Brett A.; Genden, Eric; Westra, William H.; Misiukiewicz, Krzysztof; Posner, Marshall R.; Bakst, Richard L.
Objectives: As the human papillomavirus (HPV) epidemic continues to grow, the number of elderly patients with oropharyngeal squamous cell carcinoma (OPSCC) is rapidly increasing. Despite this observation, this cohort remains understudied. We aimed to understand HPV prevalence and characteristics within this cohort as well as its impact on disease control in elderly patients. Methods and Materials: We identified patients aged >= 70 with newly diagnosed, non-metastatic, OPSCC treated with curative intent at our institution from 2007 to 2018. Logistic regression and survival analyses were used for outcome-specific endpoints. Results: In total, 88 patients were identified with a median age of 73 (interquartile range [IQR]: 71-78) and a median Charlson Comorbidity Index of 6 (IQR: 5-7). Eighty-two percent were ECOG 0 or 1 performance. Of note, 70% of the cohort had HPV + tumors. Fifty-one percent of patients were AJCC 8th edition stage I/II and 49% were stage III/IV. Median follow-up time was 2.5 years (IQR: 0.9-4.7). Eight percent had surgery alone, 27% underwent adjuvant RT, and 64% received definitive RT. Sixty-four percent received concurrent chemotherapy. By both univariate and multivariable analyses, HPV + status was significantly associated with improved locoregional control (LRC), overall survival (OS), and disease specific survival (DSS). Conclusions: In our cohort of elderly patients with OPSCC, the majority was HPV +, which was associated with improved clinical outcomes. There are many challenges when managing elderly patients with OPSCC, but as the population ages and the HPV epidemic evolves, these patients should be considered for elderly specific clinical trials.
Knowledge, health beliefs, and preventive behavior regarding cervical cancer among Turkish women: a cross sectional study
JOURNAL OF PUBLIC HEALTH-HEIDELBERG
Authors: Kirag, Nukhet
Aim This study aimed to evaluate knowledge, health belief, and preventive behavior regarding cervical cancer among Turkish Women. Subjects and methods This cross-sectional descriptive study was conducted from May to June 2019 in the province of Aydin, Turkey, with a total of 131 women. The data were collected using questionnaires filled out by the participants and the Cancer Information Overload Scale and The Turkish version of the Cervical Cancer and HPV Awareness Questionnaire. Data were analyzed using t test, ANOVA, and Pearson correlation analysis performed using the Statistical Package for Social Sciences version 20. Results It is seen from the results of the study that married women, women who have been sexually active before, and women who had at least one pregnancy had a higher Cancer Information Overload Scale score (p < 0.05). This study showed that 56.8% of participants had not undergone a Pap smear test. Women with active smoking were less likely than those without active smoking to have a perceived seriousness score (15.82 +/- 4.25 vs 18.19 +/- 4.56). Women who had a Pap smear test were more likely than those who had not had a Pap smear test to have a perceived seriousness score (19.78 +/- 3.61 vs 17.30 +/- 4.94). (p < 0.05). Conclusion There is a need for more participation in the Pap smear test. This study showed a high level of perceived seriousness increased Pap smear test screening. Aside from studies evaluating the knowledge and practice level of the population in cervical cancer, interventional studies promoting the development of preventive behaviors would contribute significantly to the literature.