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Preventing the preventable cancer

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Preventing the preventable cancer Zero Cervical Cancer in RAK / UAE by 2020


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Fact is ……. While it is possible for a


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Global Burden of Cervical Cancer


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Courtesy Dr Jalaa Taher, HAAD


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Cytology based screening for Cervical Cancer


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Limitations of cytology


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Reproducibility of Cervical cytology after reviewing 5000 slides


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Cytology Screen categories Bethesda Scoring


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Management of women with LSIL


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Draw backs of cytology screening (Roche submission to US FDA March 2014)


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Harald zur Hausen 1984 isolated HPV 16 from Cx tissue Awarded Nobel Prize 2008


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Relative sensitivities of cytology & HPV testing


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Co Testing


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Genotypes separately & simultaneously reported by Star Metropolis Clinical Lab


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Primary HR HPV Screening with reflux cytology


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Courtesy Dr Jalaa Taher, HAAD


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Courtesy Dr Jalaa Taher, HAAD


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Courtesy Dr Jalaa Taher, HAAD


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UAE study Age distribution n = 314


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HPV Genotypes in UAE n = 126 8 LR genotypes 14 HR genotypes


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Genotype distribution in different age groups (n = 126)


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HPV genotypes in UAE 14 HR genotypes : 80 8 LR : 46


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HPV Genome E1-E7 = “Early” genes (nonstructural) L1, L2 = Capsid genes URR = upstream regulatory region E6 & E7 proteins play major role in immortality & malignant transformation of infected cells E5 has role, but not required to maintain cancer phenotype Munoz et al. 2006.


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Why Cervical Cancer is preventable ? Natural History of HPV infection


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HPV-containing double stranded DNA ‘Empty’ non-infectious virus-like particle (VLP) mimics the virus Virus-like particles (VLPs) as HPV vaccine antigens mimic the virus structure Stanley M, et al. Vaccine 2006; 24(suppl 3):S3/106–113.


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Vaccines Gardasil (2006) : Contains HPV 16, 18, 6, 11 Cerverix (2009): Contains HPV 16, 18 Females 10 through 25 For: Ca Cx CIN Adenocarcinoma in situ Gardasil for males too and for Ca Anus, warts etc


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Two Opportunities to prevent Cx Ca Normal cervix HPV infection Cervical Intraepitheilial neoplasia CIN Cervical Cancer HPV vaccine HPV & Cx screen & t/t - 18 18 – 25 > 30


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Collection of Cx Swab


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Cervical Cancer is entirely preventable Vaccination before exposure Screening after 30 yrs (every 5 yrs) Though STI, it does not imply un-faithfullness Cancer free RAK / UAE by 2020 Become a national achievable goal Insurance be instructed to approve Vaccination & Co-testing


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Please Join, Support & Promote Scientists have the tools, but cannot do it alone Thank you for your attention


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