Journal of Lower Genital Tract Disease最新文献_第3页

Performance of Government-Financed Cervical Cancer Screening in Hunan, China and Optimization of Triage Strategies.

IF 2.4 4区医学

Journal of Lower Genital Tract Disease Pub Date : 2025-02-14 DOI: 10.1097/LGT.0000000000000875

Zexi Liao, Kehan Zou, Ming Lei, Yinglan Wu, Wenqing Yang, Yu Zhang

{"title":"Performance of Government-Financed Cervical Cancer Screening in Hunan, China and Optimization of Triage Strategies.","authors":"Zexi Liao, Kehan Zou, Ming Lei, Yinglan Wu, Wenqing Yang, Yu Zhang","doi":"10.1097/LGT.0000000000000875","DOIUrl":"https://doi.org/10.1097/LGT.0000000000000875","url":null,"abstract":"Objectives: Cervical cancer is a preventable and manageable public health concern. This study aimed to evaluate the performance of a government-financed cervical cancer screening program and to discuss optimal primary screening approach and triage strategies for large-scale population screening.Methods: This population-based study was conducted from 2015 to 2020 and included 6,373,279 eligible women. The performance of the cervical cancer screening program in Hunan Province was evaluated by comparing cancer incidence and mortality rates. The screening powers of primary human papillomavirus (HPV) testing and cytology were compared by calculating positive outcomes and cervical intraepithelial neoplasia 2 or worse (CIN2+) detection rates. Triage strategies for individuals positive for HPV-16/18 after primary HPV testing were discussed by comparing the CIN2+ detection rates and associated costs.Results: The cervical cancer screening program has contributed to lower cancer mortality rates in Hunan Province. The HPV testing showed a higher CIN2+ detection rate than cytology as the primary screening approach (0.604% vs. 0.324%). For individuals positive for HPV-16/18, reflex cytology demonstrated a higher CIN2+ detection rate than direct colposcopy (51.11% vs 41.25%), although it was more expensive. For individuals with high-risk HPV types other than HPV-16/18, direct colposcopy exhibited a similar CIN2+ detection power as reflex cytology, but cost less.Conclusions: The cervical cancer screening program should be expanded because the benefits outweigh the costs. Statistical data indicate that HPV testing is a cost-effective preliminary screening approach for large-scale population screening.","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the Editor: Comorbidities in Male Patients With Lichen Sclerosus: A Case-Control Study.

IF 2.4 4区医学

Journal of Lower Genital Tract Disease Pub Date : 2025-02-14 DOI: 10.1097/LGT.0000000000000882

Fabiola Cassaro, Pietro Impellizzeri, Carmelo Romeo, Salvatore Arena

引用次数: 0

Response to the Letter to the Editor Regarding: Comorbidities in Male Patients With Lichen Sclerosus: A Case-Control Study.

IF 2.4 4区医学

Journal of Lower Genital Tract Disease Pub Date : 2025-02-14 DOI: 10.1097/LGT.0000000000000883

Niina K Hieta, Marjut A M Haataja, Lotta Tapana

引用次数: 0

Risk of Vulvar HSIL and Penile Neoplasias in Anogenital Lichen Planus: A Case-Control Study.

IF 2.4 4区医学

Journal of Lower Genital Tract Disease Pub Date : 2025-02-14 DOI: 10.1097/LGT.0000000000000879

Niina K Hieta, Lotta Tapana, Jenni M Söderlund, Jutta K Huvila, Lauri A I Talve, Marjut A M Haataja

{"title":"Risk of Vulvar HSIL and Penile Neoplasias in Anogenital Lichen Planus: A Case-Control Study.","authors":"Niina K Hieta, Lotta Tapana, Jenni M Söderlund, Jutta K Huvila, Lauri A I Talve, Marjut A M Haataja","doi":"10.1097/LGT.0000000000000879","DOIUrl":"https://doi.org/10.1097/LGT.0000000000000879","url":null,"abstract":"Objective: Lichen planus (LP) is a chronic inflammatory skin disease that may affect the skin, scalp, nails, and mucosa. The aim of this study was to investigate the risk of genital premalignant and malignant conditions in patients with anogenital LP (agLP).Methods: We identified 60 male and 56 female patients with agLP by searching the biobank archives for a genital or perianal skin biopsy showing LP between 2004 and 2020. We also included 10 randomly selected age- and sex-matched controls for each patient. The risks of genital cancers and their precursors were evaluated.Results: The incidence of agLP was 1.54 per 100,000 men and 1.36 per 100,000 women. There was no statistical difference between male and female incidence (p = .5721). The odds ratio (OR) for high-grade squamous intraepithelial lesion (HSIL) of the vulva was 31.2 (95% CI = 2.46-1645.00; p = .01). The OR for penile neoplasias could not be calculated because control patients had no neoplasias, but the difference was suggestive of statistical significance (95% CI = 1.90-infinite; p = .008). The mean age at the time of diagnosis of agLP was 59.9 years (median 62 years) in female patients and 40.8 years (median 33 years) in male patients. The difference in the mean ages of female and male patients was statistically significant (95% CI = 11.92-26.13; p < .001).Conclusions: Patients with agLP may have an increased risk for vulvar HSIL and penile neoplasia.","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges With Diagnosis of Labial Agglutination Due to Lichen Sclerosus.

IF 2.4 4区医学

Journal of Lower Genital Tract Disease Pub Date : 2025-02-10 DOI: 10.1097/LGT.0000000000000874

Esha Ghosalkar, Samantha Epstein, Allison Epstein, Melissa Mauskar, Rachel Pope

{"title":"Challenges With Diagnosis of Labial Agglutination Due to Lichen Sclerosus.","authors":"Esha Ghosalkar, Samantha Epstein, Allison Epstein, Melissa Mauskar, Rachel Pope","doi":"10.1097/LGT.0000000000000874","DOIUrl":"https://doi.org/10.1097/LGT.0000000000000874","url":null,"abstract":"Objective: Labial adhesion (LA) lacks a clear etiology but is associated with low estrogen levels and lichen sclerosus (LS). Genitourinary Syndrome of Menopause is a contributor due to low estrogen, needing surgical resection if symptoms persist after topical estrogen use. Early diagnosis and treatment of LS can decrease the risk of development of LA. The objective is to investigate LS prevalence as an etiological factor and evaluate the necessity for enhanced biopsy rates in LA patients.Methods: TrinetX provided data from 80 global health care centers, focusing on patients with LA using ICD-10-CM coding. The cohort was stratified based on vulva surgery 2 years post-LA diagnosis to establish a causal relationship.Results: A total of 11,875 women over the age of 18 were diagnosed with LA from 2000 to 2023. Of those, 3,673 (30.93%) underwent a surgical procedure on the female genital system within 2 years. Demographic data included a mean age of 45 years, 67.9% identified as White, 6.53% as Black/African American, 20.52% unknown, and 2.45% other races. Of the 3,673 total women, 11% had a documented biopsy prior to or with the surgery, leading to 11% (395 women) being diagnosed with LS. Limitations include inconsistent medical coding, uncertain causality between conditions, and potential data inconsistencies from the national database.Conclusions: Labial adhesion has a complex etiology, yet is associated with LS, emphasizing the need for biopsy in management when the first-line estrogen cream approach fails. Future studies on LA etiologies can improve approaches to female sexual health care disorders, enhancing patient care.","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic Accuracy of Rapid Antigen Tests for Trichomoniasis: A Meta-analysis.

IF 2.4 4区医学

Journal of Lower Genital Tract Disease Pub Date : 2025-01-22 DOI: 10.1097/LGT.0000000000000873

Ke-Yu Hsiao, Hsiu-Ling Lin, Hui-Mei Chen, Cheng-Chieh Chen

{"title":"Diagnostic Accuracy of Rapid Antigen Tests for Trichomoniasis: A Meta-analysis.","authors":"Ke-Yu Hsiao, Hsiu-Ling Lin, Hui-Mei Chen, Cheng-Chieh Chen","doi":"10.1097/LGT.0000000000000873","DOIUrl":"https://doi.org/10.1097/LGT.0000000000000873","url":null,"abstract":"Objective: Trichomoniasis is a globally prevalent sexually transmitted infection caused by the protozoan Trichomonas vaginalis. Polymerase chain reaction (PCR) is the gold standard for diagnosing trichomoniasis, but it is expensive. Antigen tests are immunochromatographic immunoassays that detect T. vaginalis membrane proteins. Despite being user-friendly and rapid, the diagnostic accuracy of antigen tests remains uncertain. Therefore, this meta-analysis aimed to evaluate the diagnostic accuracy of antigen tests for T. vaginalis infections.Materials and methods: We mined the PubMed, Embase, and Cochrane Library databases for studies evaluating the diagnostic accuracy of antigen tests for T. vaginalis. We included studies that provided diagnostic test accuracy data in order to conduct a meta-analysis. We evaluated antigen tests based on immunochromatography and lateral flow devices. The meta-analysis was conducted by using the hierarchical summary receiver operating characteristic model.Results: Eleven studies with 5,884 samples were included. The meta-analysis yielded a pooled sensitivity of 87.0% and a pooled specificity of 98.3%. A subgroup analysis employing PCR as the reference standard yielded a sensitivity of 58.5%, whereas another subgroup analysis using culture returned a sensitivity of 95.9%. The subgroup analysis of 6 studies comprising 2,328 specimens from symptomatic individuals yielded a pooled sensitivity of 85% and a specificity of 99.9%.Conclusions: The antigen tests exhibited high sensitivity and specificity. Additionally, subgroup analyses revealed that antigen tests demonstrated greater sensitivity in diagnosing symptomatic patients compared to asymptomatic individuals. While less sensitive than PCR, antigen testing remains a promising avenue for detecting T. vaginalis infections.","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Human Papillomavirus Genotype Attribution and Integration in High-Grade Vaginal Intraepithelial Neoplasia. 人乳头瘤病毒基因型、归因和整合在高级别阴道上皮内瘤变。

IF 2.4 4区医学

Journal of Lower Genital Tract Disease Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI: 10.1097/LGT.0000000000000850

Yuanming Shen, Sangsang Tang, Yumei Zhou, Qiuxue Zhang, Tingting Chen, Jingnan Li, Yu Wang, Xiaoyun Wan, Weiguo Lu, Junfen Xu

{"title":"Human Papillomavirus Genotype Attribution and Integration in High-Grade Vaginal Intraepithelial Neoplasia.","authors":"Yuanming Shen, Sangsang Tang, Yumei Zhou, Qiuxue Zhang, Tingting Chen, Jingnan Li, Yu Wang, Xiaoyun Wan, Weiguo Lu, Junfen Xu","doi":"10.1097/LGT.0000000000000850","DOIUrl":"10.1097/LGT.0000000000000850","url":null,"abstract":"Objective: The aim of the study was to investigate the distribution and association between human papillomavirus (HPV) genotypes and integration as well as their correlation with cervical lesions.Methods: Two hundred seven patients diagnosed with high-grade vaginal intraepithelial neoplasia (HG-VaIN) were recruited from the Women's Hospital School of Medicine Zhejiang University between 2015 and 2021 and assayed for HPV genotyping. HPV integration sequencing analysis was conducted using tissues from 53 patients with HG-VaIN and 4 patients with invasive vaginal carcinoma (IVC), along with paired cervical lesion specimens.Results: A total of 207 patients with HG-VaIN were categorized as having cervical lesions unrelated to HG-VaIN (group A, 71 patients, 34.30%) or cervical lesion-related HG-VaIN (group B, 136 patients, 65.70%). With an average follow-up of 42.19 months, 12 of 153 patients progressed to IVC and were all from group B. HPV16 infection and the presence of cervical lesions were the 2 main factors associated with disease progression, with cervical lesion coexistence being an independent factor. Compared with group A (5/20, 25%), group B (17/33, 51.52%) showed a higher rate of HPV integration, as demonstrated using HPV integration sequencing analysis, with HPV16 being the most integrated genotype (72.73%). The integration analysis of 4 patients with IVC paired with cervical lesion specimens showed that 3 of the 4 pairs exhibited the same HPV infection and integration sites, indicating a high degree of homology in HPV integration between cervical lesions and HG-VaIN-induced IVC.Conclusions: Patients with HG-VaIN associated with cervical lesions exhibited a higher risk of malignant transformation, necessitating more proactive treatment approaches.","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"60-67"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characterizing the Frequency and Severity of Clinical Signs and Architectural Changes in Vulvar Lichen Sclerosus. 外阴硬化地衣临床体征及结构变化的频率和严重程度。

IF 2.4 4区医学

Journal of Lower Genital Tract Disease Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI: 10.1097/LGT.0000000000000860

Madeline Ngo, Hannah R Chang, Melissa M Mauskar

引用次数: 0

The Distribution of Cervical Transformation Zone and Its Impact on Colposcopic Diagnosis: A Multicenter Study in China. 宫颈转化区的分布及其对阴道镜诊断的影响：中国的一项多中心研究

IF 2.4 4区医学

Journal of Lower Genital Tract Disease Pub Date : 2025-01-01 Epub Date: 2024-10-10 DOI: 10.1097/LGT.0000000000000838

Zichen Ye, Xiaoli Cui, Huike Wang, Mingyang Chen, Qu Lu, Yu Jiang, Peng Xue, Youlin Qiao

{"title":"The Distribution of Cervical Transformation Zone and Its Impact on Colposcopic Diagnosis: A Multicenter Study in China.","authors":"Zichen Ye, Xiaoli Cui, Huike Wang, Mingyang Chen, Qu Lu, Yu Jiang, Peng Xue, Youlin Qiao","doi":"10.1097/LGT.0000000000000838","DOIUrl":"10.1097/LGT.0000000000000838","url":null,"abstract":"Objective: The value of the transformation zone (TZ) is often overlooked in clinical settings. This study aims to assess TZ distribution, associated factors, and its impact on colposcopic diagnosis.Methods: χ 2 tests were used to analyze demographics, clinical history, and tissue samples to examine the differences in TZ distribution. Factors affecting the TZ were explored using logistic regression, and diagnostic indicators were calculated.Results: A total of 5,302 individual datasets were finally included. TZ1, TZ2, and TZ3 accounted for 31.6%, 38.5%, and 30.0%, respectively. Age is the most important factor that influences the location of the TZ. The proportion of TZ3 steadily increased with age, comprising over 55% in women over 50. The colposcopic diagnostic performance shows that high-grade squamous intraepithelial lesion or worse (HSIL+) sensitivity of TZ3 (58.1%, 95% confidence interval [CI] = 52.9-63.4) is significantly lower than that of TZ1 (69.8%, 95% CI = 65.5-74.1) and TZ2 (73.2%, 95% CI = 69.7-76.8). The HSIL+ specificity of TZ3 (96.3, 95% CI = 95.3-97.4) was higher than that of TZ1 (96.3, 95% CI = 95.2-97.3) and TZ2 (92.5, 95% CI = 91.1-93.9). The HSIL+ positive predictive value (81.3%, 95% CI = 76.4-86.2) and negative predictive value (89.3%, 95% CI = 87.6-90.9) for TZ3 are high, with no significant differences when compared with TZ1 and TZ2.Conclusions: Age predominantly influences TZ location, with TZ3 being most frequently found in women over 50. While TZ3 poses a higher risk of missed diagnosis during colposcopy, it remains clinically valuable in identifying diseased and nondiseased status. Increasing colposcopists' awareness of TZ importance is needed in clinical practice.","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"6-12"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in Cervical and Anal Cancer Incidence and Mortality in the United States. 美国宫颈癌和肛门癌发病率和死亡率的趋势。

IF 2.4 4区医学

Journal of Lower Genital Tract Disease Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI: 10.1097/LGT.0000000000000859

Tyler R McKinnish, Lindsay M Kuroki, Julie K Schwarz, Angela L Mazul

{"title":"Trends in Cervical and Anal Cancer Incidence and Mortality in the United States.","authors":"Tyler R McKinnish, Lindsay M Kuroki, Julie K Schwarz, Angela L Mazul","doi":"10.1097/LGT.0000000000000859","DOIUrl":"10.1097/LGT.0000000000000859","url":null,"abstract":"Objectives: This article describe trends in the incidence and mortality of cervical (CC) and anal (AC) cancers by race and neighborhood socioeconomic status.Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to construct a cohort of CC and AC cases from 2006 to 2018. Incidence rates and survival were calculated by race and neighborhood socioeconomic status (nSES). Annual percent change (APC) in incidence was calculated using linear regression, and 5-year overall survival (OS) by the Kaplan-Meier method.Results: Of the cases, 33,487 CC and 16,018 AC cases were identified. Women of low nSES were nearly 4 times more likely to be diagnosed with cervical cancer than those of high nSES. Cervical cancer incidence declined marginally in all groups except for low nSES women who are White (APC 0.0). Women who are Black had lower 5-year OS than their nSES counterparts of other races (most notably for Black women of low nSES 53% vs White 63%). Similarly, the low nSES AC cohort contained nearly 3 times the number of diagnoses as the high nSES cohort. AC incidence increased most in women who are White (APC 1.8 and 2.2 for low and high nSES) and men who are Black and low nSES (APC 3.3). Five-year OS was lowest for men who are Asian American and Pacific Islander (40% and 50% for low and high nSES, respectively).Conclusions: These data suggest a strong correlation between nSES, race, and their interaction on the incidence and survival trends of HPV-related disease and highlight inconsistent effects between cervical and anal cancers.","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"48-54"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0