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1. Abstract PO-037: Biomarkers for early diagnosis of human papillomavirus-related oropharyngeal cancer

   https://doi.org/10.1158/1557-3265.aacrahns23-po-037  

   Dahlstrom, Kristina R; Anderson, Karen S; Sturgis, Erich M (September 2023, Clinical Cancer Research)

   Abstract Introduction: To counteract the rapidly increasing incidence of human papillomavirus (HPV)-related oropharyngeal cancer (OPC), development of effective biomarkers and other novel screening strategies are necessary to effectively detect early disease in well-defined high-risk populations. The most promising biomarkers are circulating tumor HPV DNA (ctHPV), antibodies (Abs) to HPV16 early (E) antigens, and persistent infection with oral oncogenic HPV. Here, we report the prevalence of ctHPV in a population of middle-aged men, a group with high OPC incidence, and evaluate concordance between the three HPV biomarkers. Materials and Methods: We included participants enrolled in the HPV-related Oropharyngeal and Uncommon Cancers Screening Trial of Men (HOUSTON) study between April 2017 and December 2019. The HOUSTON study was designed to evaluate biomarkers and novel screening strategies for HPV-related cancers among middle-aged men (50-64 years), the group with the highest incidence of HPV-related OPC. We tested plasma for ctHPV using a digital droplet polymerase chain reaction (ddPCR) assay (NavDx, Naveris, Waltham, MA). We previously tested the plasma from these participants for HPV16 E Abs using a novel RAPID ELISA and for prevalent oral HPV16 (oHPV16) infection in oral rinse using the cobas HPV Test (Roche Diagnostics, Indianapolis, IN). We used Fisher’s exact test to determine statistical significance for the association between biomarkers (alpha < 0.05). Results: Of 345 samples tested, 343 were adequate for ctHPV analysis. Of these, 314 were negative (92.4%) and two were positive (0.6%; both for HPV16). Twenty-four had an indeterminate (Ind) result (7.0%), meaning ctHPV levels fell outside the established parameters for a negative or positive results. All three markers were available for 340 samples with the following results: ctHPV+/Ab+/oHPV16+: 1 (0.3%); ctHPV+/Ab-/oHPV16-: 1 (0.3%); ctHPV Ind/Ab-/oHPV16+: 3 (0.9%); ctHPV Ind/Ab-/oHPV16-: 21 (6.2%); ctHPV-/Ab+/oHPV16+: 1 (0.3%); ctHPV-/Ab+/oHPV16-: 3 (0.9%); ctHPV-/Ab-/oHPV16+: 16 (4.7%); ctHPV-/Ab-/oHPV16-: 294 (86.5%); all other combinations had no observations. ctHPV was associated with HPV16 E Abs and oHPV16 status individually and combined (individually, p = 0.032 for both and combined, p = 0.025). A ctHPV-/Ab+/oHPV16-man was diagnosed with an anal low-grade squamous intraepithelial lesion and was persistently high-risk HPV-positive at the right tonsil/base of tongue. One man was positive for all three markers and was subsequently diagnosed with stage II (T1N1) HPV16-positive/Epstein-Barr-negative nasopharyngeal cancer four months following study enrollment. Conclusions: ctHPV was rare in a general population of middle-aged men. Our results suggest that these markers in combination may be able to correctly identify early HPV-related cancers. Larger studies are needed to confirm this finding. The authors accept sole responsibility for the statements in this abstract. Citation Format: Kristina R. Dahlstrom, Karen S. Anderson, Erich M. Sturgis. Biomarkers for early diagnosis of human papillomavirus-related oropharyngeal cancer [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Innovating through Basic, Clinical, and Translational Research; 2023 Jul 7-8; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2023;29(18_Suppl):Abstract nr PO-037. 

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2. Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review

   https://doi.org/10.3389/fpubh.2022.908302  

   Musekiwa, Alfred; Moyo, Maureen; Mohammed, Mohanad; Matsena-Zingoni, Zvifadzo; Twabi, Halima Sumayya; Batidzirai, Jesca Mercy; Singini, Geoffrey Chiyuzga; Kgarosi, Kabelo; Mchunu, Nobuhle; Nevhungoni, Portia; et al (June 2022, Frontiers in Public Health)

   BackgroundCancer remains a major public health problem, especially in Sub-Saharan Africa (SSA) where the provision of health care is poor. This scoping review mapped evidence in the literature regarding the burden of cervical, breast and prostate cancers in SSA. MethodsWe conducted this scoping review using the Arksey and O'Malley framework, with five steps: identifying the research question; searching for relevant studies; selecting studies; charting the data; and collating, summarizing, and reporting the data. We performed all the steps independently and resolved disagreements through discussion. We used Endnote software to manage references and the Rayyan software to screen studies. ResultsWe found 138 studies that met our inclusion criteria from 2,751 studies identified through the electronic databases. The majority were retrospective studies of mostly registries and patient files (n= 77, 55.8%), followed by cross-sectional studies (n= 51, 36.9%). We included studies published from 1990 to 2021, with a sharp increase from 2010 to 2021. The quality of studies was overall satisfactory. Most studies were done in South Africa (n= 20) and Nigeria (n= 17). The majority were on cervical cancer (n= 93, 67.4%), followed by breast cancer (67, 48.6%) and the least were on prostate cancer (48, 34.8%). Concerning the burden of cancer, most reported prevalence and incidence. We also found a few studies investigating mortality, disability-adjusted life years (DALYs), and years of life lost (YLL). ConclusionsWe found many retrospective record review cross-sectional studies, mainly in South Africa and Nigeria, reporting the prevalence and incidence of cervical, breast and prostate cancer in SSA. There were a few systematic and scoping reviews. There is a scarcity of cervical, breast and prostate cancer burden studies in several SSA countries. The findings in this study can inform policy on improving the public health systems and therefore reduce cancer incidence and mortality in SSA. 

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3. The effect of screening on the health burden of chlamydia: An evaluation of compartmental models based on person-days of infection

   https://doi.org/10.3934/mbe.2023720  

   Farrell, Jack; Spolyar, Owen; Greenhalgh, Scott (January 2023, Mathematical Biosciences and Engineering)

   Sexually transmitted diseases (STDs) are detrimental to the health and economic well-being of society. Consequently, predicting outbreaks and identifying effective disease interventions through epidemiological tools, such as compartmental models, is of the utmost importance. Unfortunately, the ordinary differential equation compartmental models attributed to the work of Kermack and McKendrick require a duration of infection that follows the exponential or Erlang distribution, despite the biological invalidity of such assumptions. As these assumptions negatively impact the quality of predictions, alternative approaches are required that capture how the variability in the duration of infection affects the trajectory of disease and the evaluation of disease interventions. So, we apply a new family of ordinary differential equation compartmental models based on the quantity person-days of infection to predict the trajectory of disease. Importantly, this new family of models features non-exponential and non-Erlang duration of infection distributions without requiring more complex integral and integrodifferential equation compartmental model formulations. As proof of concept, we calibrate our model to recent trends of chlamydia incidence in the U.S. and utilize a novel duration of infection distribution that features periodic hazard rates. We then evaluate how increasing STD screening rates alter predictions of incidence and disability adjusted life-years over a five-year horizon. Our findings illustrate that our family of compartmental models provides a better fit to chlamydia incidence trends than traditional compartmental models, based on Akaike information criterion. They also show new asymptomatic and symptomatic infections of chlamydia peak over drastically different time frames and that increasing the annual STD screening rates from 35% to 40%-70% would annually avert 6.1-40.3 incidence while saving 1.68-11.14 disability adjusted life-years per 1000 people. This suggests increasing the STD screening rate in the U.S. would greatly aid in ongoing public health efforts to curtail the rising trends in preventable STDs. 

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4. Disease burden among Ukrainians forcibly displaced by the 2022 Russian invasion

   https://doi.org/10.1073/pnas.2215424120  

   Pandey, Abhishek; Wells, Chad R.; Stadnytskyi, Valentyn; Moghadas, Seyed M.; Marathe, Madhav V.; Sah, Pratha; Crystal, William; Meyers, Lauren Ancel; Singer, Burton H.; Nesterova, Olena; et al (February 2023, Proceedings of the National Academy of Sciences)

   The Russian invasion of Ukraine on February 24, 2022, has displaced more than a quarter of the population. Assessing disease burdens among displaced people is instrumental in informing global public health and humanitarian aid efforts. We estimated the disease burden in Ukrainians displaced both within Ukraine and to other countries by combining a spatiotemporal model of forcible displacement with age- and gender-specific estimates of cardiovascular disease (CVD), diabetes, cancer, HIV, and tuberculosis (TB) in each of Ukraine’s 629 raions (i.e., districts). Among displaced Ukrainians as of May 13, we estimated that more than 2.63 million have CVDs, at least 615,000 have diabetes, and over 98,500 have cancer. In addition, more than 86,000 forcibly displaced individuals are living with HIV, and approximately 13,500 have TB. We estimated that the disease prevalence among refugees was lower than the national disease prevalence before the invasion. Accounting for internal displacement and healthcare facilities impacted by the conflict, we estimated that the number of people per hospital has increased by more than two-fold in some areas. As regional healthcare systems come under increasing strain, these estimates can inform the allocation of critical resources under shifting disease burdens. 

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5. Disease burden among Ukrainians forcibly displaced by the 2022 Russian invasion.

   Abhishek Pandey; Chad R Wells; Valentyn Stadnytskyi; Seyed M Moghadas; Madhav V Marathe; Pratha Sah; William Crystal; Lauren Ancel Meyers; Burton H Singer; Olena Nesterova; et al (February 2023, PNAS nexus)

   The Russian invasion of Ukraine on February 24, 2022, has displaced more than a quarter of the population. Assessing disease burdens among displaced people is instrumental in informing global public health and humanitarian aid efforts. We estimated the disease burden in Ukrainians displaced both within Ukraine and to other countries by combining a spatiotemporal model of forcible displacement with age- and gender-specific estimates of cardiovascular disease (CVD), diabetes, cancer, HIV, and tuberculosis (TB) in each of Ukraine's 629 raions (i.e., districts). Among displaced Ukrainians as of May 13, we estimated that more than 2.63 million have CVDs, at least 615,000 have diabetes, and over 98,500 have cancer. In addition, more than 86,000 forcibly displaced individuals are living with HIV, and approximately 13,500 have TB. We estimated that the disease prevalence among refugees was lower than the national disease prevalence before the invasion. Accounting for internal displacement and healthcare facilities impacted by the conflict, we estimated that the number of people per hospital has increased by more than two-fold in some areas. As regional healthcare systems come under increasing strain, these estimates can inform the allocation of critical resources under shifting disease burdens. 

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