Browsing by Author "Baena, A"

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Distribution of human papillomavirus genotypes by severity of cervical lesions in HPV screened positive women from the ESTAMPA study in Latin America
(Public Library of Science, 2022) Correa, RM; Baena, A; Valls, J; Colucci, MC; Mendoza, L; Rol, M; Wiesner, C; Ferrera, A; Fellner, MD; González, JV; Basiletti, JA; Mongelos, P; de la Peña, MR; Saino, A; Kasamatsu, E; Velarde, C; Macavilca, N; Martinez, S; Venegas, G; Calderón, A; Rodriguez, G; Barrios, H; Herrero, R; Almonte, M; Picconi, MA; Padín, VM; Mural, J; Figueredo, AI; Borelli, MA; Falabella, PG; Kaznowiecki, NG; García, S; Moreno, A; Guyot, J; Lencioni, MA; Cattarin, N; Quinteiro, M; González, AP; Hernandez, MB; Solano, EG; Quesada, CS; Monet, RP; Hidalgo, RF; Arias, JG; Cabrera, Y; Rodriguez, MI; Paez, M; Castro, A; Centurión, C; Báez, R; Vester, J; Soilán, A; Ortega, M; Cristaldo, C
The proportion of HPV16 and 18-associated cervical cancer (CC) appears rather constant worldwide (≥70%), but the relative importance of the other HR-HPV differs slightly by geographical region. Here, we studied the HPV genotype distribution of HPV positive Latin American (LA) women by histological grade, in a sub-cohort from the ESTAMPA study
Latin America and the Caribbean Code Against Cancer 1st Edition: Medical interventions including hormone replacement therapy and cancer screening
(Elsevier Ltd, 2023) Baena, A; Paolino, M; Villarreal-Garza, C; Torres, G; Delgado, L; Ruiz, R; Canelo-Aybar, C; Song, Y; Feliu, A; Maza, M; Jeronimo, J; Espina, C; Almonte, M
Prostate, breast, colorectal, cervical, and lung cancers are the leading cause of cancer in Latin America and the Caribbean (LAC) accounting for nearly 50% of cancer cases and cancer deaths in the region. Following the IARC Code Against Cancer methodology, a group of Latin American experts evaluated the evidence on several medical interventions to reduce cancer incidence and mortality considering the cancer burden in the region. A recommendation to limit the use of HRT was issued based on the risk associated to develop breast, endometrial, and ovarian cancer and on growing concerns related to the over-the-counter and without prescription sales, which in turn bias estimations on current use in LAC. In alignment with WHO breast and cervical cancer initiatives, biennial screening by clinical breast examination (performed by trained health professionals) from the age of 40 years and biennial screening by mammography from the age of 50 years to 74, as well as cervical screening by HPV testing (either self-sampling or provider-sampling) every 5–10 years for women aged 30–64 years, were recommended. The steadily increasing rates of colorectal cancer in LAC also led to recommend colorectal screening by occult blood testing every two years or by endoscopic examination of the colorectum every 10 years for both men and women aged 50–74 years. After evaluating the evidence, the experts decided not to issue recommendations for prostate and lung cancer screening; while there was insufficient evidence on prostate cancer mortality reduction by prostate-specific antigen (PSA) testing, there was evidence of mortality reduction by low-dose computed tomography (LDCT) targeting high-risk individuals (mainly heavy and/or long-term smokers) but not individuals with average risk to whom recommendations of this Code are directed. Finally, the group of experts adapted the gathered evidence to develop a competency-based online microlearning program for building cancer prevention capacity of primary care health professionals.
Performance of visual inspection of the cervix with acetic acid (VIA) for triage of HPV screen-positive women: results from the ESTAMPA study
(John Wiley and Sons Inc, 2023) Baena, A; Mesher, D; Salgado, Y; Martínez, S; Villalba, GR; Amarilla, ML; Salgado, B; Flores, B; Bellido-Fuentes, Y; Álvarez-Larraondo, M; Valls, J; Lora, O; Virreira-Prout, G; Figueroa, J; Turcios, E; Soilán, AM; Ortega, M; Celis, M; González, M; Venegas, G; Terán, C; Ferrera, A; Mendoza, L; Kasamatsu, E; Murillo, R; Wiesner, C; Broutet, N; Luciani, S; Herrero, R; Almonte, M
VIA is recommended for triage of HPV-positive women attending cervical screening. In the multicentric ESTAMPA study, VIA performance for detection of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) among HPV-positive women was evaluated. Women aged 30-64 years were screened with HPV testing and cytology and referred to colposcopy if either test was positive. At colposcopy visit, study-trained midwives/nurses/GPs performed VIA ahead of colposcopy. VIA was considered positive if acetowhite lesions were observed in or close to the transformation zone. Ablative treatment eligibility was assessed for VIA positives. Performance indicators were estimated. Three thousand one hundred and forty-two HPV-positive women were included. Sensitivity for CIN3+ was 85.9% (95% CI 81.2-89.5) among women <50 years and, although not significant, slightly lower in women 50+ (78.0%, 95% CI 65.9-86.6). Overall specificity was 58.6% (95% CI 56.7-60.5) and was significantly higher among women 50+ (70.3%, 95% CI 66.8-73.5) compared to women <50 (54.3%, 95% CI 52.1-56.5). VIA positivity was lower among women 50+ (35.2%, 95% CI 31.9-38.6) compared to women <50 (53.2, 95% CI 51.1-55.2). Overall eligibility for ablative treatment was 74.5% and did not differ by age. VIA sensitivity, specificity, and positivity, and ablative treatment eligibility varied highly by provider (ranges: 25%-95.4%, 44.9%-94.4%, 8.2%-65.3%, 0%-98.7%, respectively). VIA sensitivity for cervical precancer detection among HPV-positive women performed by trained providers was high with an important reduction in referral rates. However, scaling-up HPV screening triaged by VIA will be challenging due to the high variability of VIA performance and providers' need for training and supervision.