High performance of the DNA methylation-based WID-qEC test for detecting uterine cancers independent of sampling modalities.

Endometrial cancer (EC) is the most prevalent gynaecological cancer in high-income countries and its incidence is continuing to rise sharply. Simple and objective tools to reliably detect women with EC are urgently needed. We recently developed and validated the DNA methylation (DNAme)-based women's cancer risk identification-quantitative polymerase chain reaction test for endometrial cancer (WID-qEC) test that could address this need. Here, we demonstrate that the stability of the WID-qEC test remains consistent regardless of: (i) the cervicovaginal collection device and sample media used (Cervex brush and PreservCyt or FLOQSwab and eNAT), (ii) the collector of the specimen (gynaecologist- or patient-based), and (iii) the precise sampling site (cervical, cervicovaginal and vaginal). Furthermore, we demonstrate sample stability in eNAT medium for 7 days at room temperature, greatly facilitating the implementation of the test into diagnostic laboratory workflows. When applying FLOQSwabs (Copan) in combination with the eNAT (Copan) sample collection media, the sensitivity and specificity of the WID-qEC test to detect uterine (i.e., endometrial and cervical) cancers in gynaecologist-taken samples was 92.9% (95% confidence interval [CI] = 75.0%-98.8%) and 98.6% (95% CI = 91.7%-99.9%), respectively, whilst the sensitivity and specificity in patient collected self-samples was 75.0% (95% CI = 47.4%-91.7%) and 100.0% (95% CI = 93.9%-100.0%), respectively. Taken together these data confirm the robustness and clinical potential of the WID-qEC test.

Racioethnic Disparities in Endometrial Cancer Outcomes.

Black women are twice as likely to die from endometrial cancer (EC) compared with white women. This represents one of the worst racioethnic disparities amongst all cancers globally. Compared with white women, black women are more likely to be diagnosed with advanced EC, have more barriers to accessing care and experience increased delays in obtaining an EC diagnosis and commencing treatment. Histological and molecular differences place black women at higher risk of being diagnosed with more aggressive EC subtypes that carry less favourable outcomes. Furthermore, EC diagnostic pathways are less reliable in black women, and black women are less likely to receive evidence-based treatment for EC. This racioethnic disparity in EC outcomes exists both in the UK and US, despite differences in healthcare systems. This review methodically describes the key factors along the patient journey that contribute to the disparity in black women and proposes multifaceted approaches to lessen these gaps.

Updates on HPV Vaccination.

Cervical cancer still poses a significant global challenge. Developed countries have mitigated this challenge by the introduction of structured screening programmes and, more recently, the HPV vaccine. Countries that have successfully introduced national HPV vaccination programmes are on course for cervical cancer elimination in a few decades. In developing countries that lack structured screening and HPV vaccination programmes, cervical cancer remains a major cause of morbidity and mortality. The HPV vaccine is key to addressing the disproportionate distribution of cervical cancer incidence, with much to be gained from increasing vaccine coverage and uptake globally. This review covers the history and science of the HPV vaccine, its efficacy, effectiveness and safety, and some of the considerations and challenges posed to the achievement of global HPV vaccination coverage and the consequent elimination of cervical cancer.

Factors Associated with the Uptake of Antenatal Tetanus Toxoids Containing Vaccine by First-Time Mothers in Nigeria: Findings from the 2018 Nigerian Demographic Health Survey.

Background: Maternal and neonatal tetanus remains a public health problem in low-and-middle-income countries despite the increasing investment in tetanus toxoid containing vaccines (TTCV). Nigeria still records fatalities from tetanus, predominantly in women of reproductive age and in newborns. This is largely due to poor access to vaccinations and high rates of unsupervised labour and childbirth. We aim to investigate the antenatal uptake of TTCV and associated factors among first-time pregnant women in Nigeria. Methods: Data obtained from the 2018 Nigeria Demographic Health Survey (NDHS) was used to generate a list of eligible patients who in the last five years had undergone their first childbirth experience. Data was analysed using univariable and multivariable analyses and reported using a 95% confidence interval. Results: A total of 3640 participants were included in the analysis. 59.6% (95% CI, 57.6-61.8) of participants had received at least two doses of TTCV. Uptake of TTCV irrespective of current marital status was independently associated with number of and place of antenatal care. Other factors associated with receiving two doses of TTCV in all participants were ownership of mobile phones and region of residence. Among the currently married participants, wealth quintiles, region of residence, and having a polygamous family were additional associated factors. Conclusion: There was low uptake of the minimal required dosage of TTCV among first-time pregnant women with the lowest uptake in Northern regions relative to Southern regions. We recommend mixed methods studies to further explore the motivation behind TTCV uptake in pregnant women which can help guide future policies and interventions to improve uptake of tetanus immunization in Nigeria.