Browsing by Author "Van De Wyngard, Vanessa"
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- ItemA Pooled Analysis to Compare the Clinical Characteristics of Human Papillomavirus-positive and -Negative Cervical Precancers(2020) Castle, Philip E.; Pierz, Amanda J.; Adcock, Rachael; Aslam, Shagufta; Basu, Partha S.; Belinson, Jerome L.; Cuzick, Jack; El-Zein, Mariam; Ferreccio, Catterina; Firnhaber, Cynthia; Franco, Eduardo L.; Gravitt, Patti E.; Isidean, Sandra D.; Lin, John; Mahmud, Salaheddin M.; Monsonego, Joseph; Muwonge, Richard; Ratnam, Samuel; Safaeian, Mahboobeh; Schiffman, Mark; Smith, Jennifer S.; Swarts, Avril; Wright, Thomas C.; Van De Wyngard, Vanessa; Xi, Long FuGiven that high-risk human papillomavirus (HPV) is the necessary cause of virtually all cervical cancer, the clinical meaning of HPV-negative cervical precancer is unknown. We, therefore, conducted a literature search in Ovid MEDLINE, PubMed Central, and Google Scholar to identify English-language studies in which (i) HPV-negative and -positive, histologically confirmed cervical intraepithelial neoplasia grade 2 or more severe diagnoses (CIN2+) were detected and (ii) summarized statistics or deidentified individual data were available to summarize proportions of biomarkers indicating risk of cancer. Nineteen studies including 3,089 (91.0%) HPV-positive and 307 (9.0%) HPV-negative CIN2+ were analyzed. HPV-positive CIN2+ (vs. HPV-negative CIN2+) was more likely to test positive for biomarkers linked to cancer risk: a study diagnosis of CIN3+ (vs. CIN2; 18 studies; 0.56 vs. 0.24; P < 0.001) preceding high-grade squamous intraepithelial lesion cytology (15 studies; 0.54 vs. 0.10; P < 0.001); and high-grade colposcopic impression (13 studies; 0.30 vs. 0.18; P = 0.03). HPV-negative CIN2+ was more likely to test positive for low-risk HPV genotypes than HPV-positive CIN2+ (P < 0.001). HPV-negative CIN2+ appears to have lower cancer risk than HPV-positive CIN2+. Clinical studies of human high-risk HPV testing for screening to prevent cervical cancer may refer samples of HPV test-negative women for disease ascertainment to correct verification bias in the estimates of clinical performance. However, verification bias adjustment of the clinical performance of HPV testing may overcorrect/underestimate its clinical performance to detect truly precancerous abnormalities.
- ItemCohort Profile : The Maule Cohort (MAUCO)(2020) Ferreccio Readi, Catterina; Huidobro, A.; Cortés Arancibia, Sandra; Bambs S., Claudia; Toro Espinoza, Pablo Esteban; Van De Wyngard, Vanessa; Acevedo Romo, Johanna Patricia; Verdejo Pinochet, Hugo; Cook, María Paz; Castro Gálvez, Pablo Federico; Cruz Olivos, Francisco; Corvalán R., Alejandro; Paredes, F.; Venegas, P.; Oyarzún González, X.; Foerster, C.; Vargas, C.; Koshiol, J.; Araya, J. C.; Quest, A. F.; Kogan, M. J.; Lavandero, S.; MAUCO Study Group; CEDEUS (Chile)
- ItemDistribution of dysplasia and cancer in the gallbladder : an analysis from a high cancer-risk population(2018) Koshiol, Jill; Bellolio, Enrique; Vivallo, Carolina; Cook, María Paz; McGee, Emma E.; Losada, Héctor; Van Dyke, Alison L.; Van De Wyngard, Vanessa; Prado, Rodrigo; Villaseca, Miguel; Riquelme, Pía; Acevedo, Johanna; Olivo, Vanessa; Pettit, Karen; Hildesheim, Allan; Medina, Karie; Memis, Bahar; Adsay, Volkan; Ferreccio Readi, Catterina; Araya, Juan Carlos
- ItemEarly detection of cervical cancer in Chile: time for change(SOC MEDICA SANTIAGO, 2014) Leniz Martelli, Javiera; Van De Wyngard, Vanessa; Lagos, Marcela; Isabel Barriga, Maria; Puschel Illanes, Klaus; Ferreccio Readi, CatterinaMortality rates for cervical cancer (CC) in Chile are higher than those of developed countries and it has an unequal socioeconomic distribution. The recognition of human papilloma virus (HPV) as the causal agent of cervical cancer in the early 80's changed the prevention paradigms. Current goals are to prevent HPV infection by vaccination before the onset of sexual activity and to detect HPV infection in women older than 30 years. This article reviews CC prevention and early detection methods, discusses relevant evidence to support a change in Chile and presents an innovation proposal. A strategy of primary screening based on HPV detection followed by triage of HPV-positive women by colposcopy in primary care or by cytological or molecular reflex testing is proposed. Due to the existence in Chile of a well-organized nationwide CC prevention program, the replacement of a low-sensitivity screening test such as the Papanicolau test with a highly sensitive one such as HPV detection, could quickly improve the effectiveness of the program. The program also has a network of personnel qualified to conduct naked-eye inspections of the cervix, who could easily be trained to perform triage colposcopy. The incorporation of new prevention strategies could reduce the deaths of Chilean women and correct inequities.
- ItemHandgrip strength as a predictor of adverse health outcomes(2022) Concha-Cisternas, Yeny; Petermann-Rocha, Fanny; Castro-Pinero, Jose; Parra, Solage; Albala, Cecilia; Van De Wyngard, Vanessa; Vasquez, Jaime; Cigarroa, Igor; Celis-Morales, CarlosMuscle strength can be measured through different methods and handgrip strength is one of the most used techniques in epidemiological studies. Given its easy application, high reliability, and low cost, it is considered an important health biomarker. Handgrip strength is associated with adverse health outcomes such as mortality and risk of developing chronic diseases, cardiovascular, respiratory, cancer and dementia. There is a paucity of evidence in Chile about the association of handgrip strength with these health outcomes limiting its visibility and implementation in clinical settings. Therefore, this narrative review summarizes the scientific evidence about the association of grip strength with non-communicable chronic diseases and mortality in middle age and older adults.
- ItemHigh-risk HPV infection after five years in a population-based cohort of Chilean women(2011) Ferreccio Readi, Catterina; Van De Wyngard, Vanessa; Domínguez, M. A.; Puschel Illanes, Klaus; Corvalán R., Alejandro; Olcay, Fabiola; Franceschi, Silvia; Snijders, Peter J.; Ferreccio Readi, Catterina; Van De Wyngard, Vanessa; Domínguez, M. A.; Puschel Illanes, Klaus; Corvalán R., Alejandro; Olcay, Fabiola; Franceschi, Silvia; Snijders, Peter J.Abstract Background The need to review cervical cancer prevention strategies has been triggered by the availability of new prevention tools linked to human papillomavirus (HPV): vaccines and screening tests. To consider these innovations, information on HPV type distribution and natural history is necessary. This is a five-year follow-up study of gynecological high-risk (HR) HPV infection among a Chilean population-based cohort of women. Findings A population-based random sample of 969 women from Santiago, Chile aged 17 years or older was enrolled in 2001 and revisited in 2006. At both visits they answered a survey on demographics and sexual history and provided a cervical sample for HPV DNA detection (GP5+/6+ primer-mediated PCR and Reverse line blot genotyping). Follow-up was completed by 576 (59.4%) women; 45 (4.6%) refused participation; most losses to follow-up were women who were unreachable, no longer eligible or had missing samples. HR-HPV prevalence increased by 43%. Incidence was highest in women < 20 years of age (19.4%) and lowest in women > 70 (0%); it was three times higher among women HR-HPV positive versus HPV negative at baseline (25.5% and 8.3%; OR 3.8, 95% CI 1.8-8.0). Type-specific persistence was 35.3%; it increased with age, from 0% in women < 30 years of age to 100% in women > 70. An enrollment Pap result ASCUS or worse was the only risk factor for being HR-HPV positive at both visits. Conclusions HR-HPV prevalence increased in the study population. All HR-HPV infections in women < 30 years old cleared, supporting the current recommendation of HR-HPV screening for women > 30 years.
- ItemHPV16/18 genotyping for the triage of HPV positive women in primary cervical cancer screening in Chile(2015) Lagos Lucero, Marcela; Van De Wyngard, Vanessa; Poggi, Helena; Cook, María Paz; Viviani García, Paola; Barriga Cosmelli, María Isabel; Ferreccio Readi, Catterina; Pruyas, Martha; Lagos Lucero, Marcela; Van De Wyngard, Vanessa; Poggi, Helena; Cook, María Paz; Viviani, Paola; Barriga, María I.; Ferreccio Readi, Catterina; Pruyas, MarthaAbstract Background We previously conducted a population-based screening trial of high-risk human papillomavirus (hrHPV) testing and conventional cytology, demonstrating higher sensitivity (92.7 % vs 22.1 % for CIN2+) but lower positive predictive value (10.5 % vs 23.9 %) of hrHPV testing. Here we report the performance of HPV16/18 genotyping to triage the hrHPV positive participants. Methods Women aged 25 years and older received hrHPV (Hybrid Capture 2) and Papanicolaou testing; positives by either test underwent colposcopy and directed biopsy, as did a sample of double-negatives. hrHPV positive women were reflex-tested with HPV16/18 genotyping (Digene HPV Genotyping PS Test). Results Among the 8,265 participants, 10.7 % were hrHPV positive, 1.7 % had ASCUS+ cytology, 1.2 % had CIN2+; 776 (88 %) hrHPV positive women had complete results, of whom 38.8 % were positive for HPV16 (24.0 %), HPV18 (9.7 %) or both (5.1 %). CIN2+ prevalence in HPV16/18 positive women (16.3 %, 95 % CI 12.3-20.9) was twice that of HPV16/18 negative women (8.0 %, 95 % CI 5.7-10.8). HPV16/18 genotyping identified 40.5 % of CIN2, 66.7 % of CIN3 and 75.0 % of cancers. Compared to hrHPV screening alone, HPV16/18 triage significantly reduced the referral rate (10.7 % vs 3.7 %) and the number of colposcopies required to detect one CIN2+ (9 vs 6). When HPV16/18 negative women with baseline ASCUS+ cytology were also colposcopied, an additional 14 % of CIN2+ was identified; referral increased slightly to 4.2 %. Conclusions HPV16/18 triage effectively stratified hrHPV positive women by their risk of high-grade lesions. HPV16/18 positive women must be referred immediately; referral could be deferred in HPV16/18 negative women given the slower progression of non-HPV16/18 lesions, however, they will require active follow-up.Abstract Background We previously conducted a population-based screening trial of high-risk human papillomavirus (hrHPV) testing and conventional cytology, demonstrating higher sensitivity (92.7 % vs 22.1 % for CIN2+) but lower positive predictive value (10.5 % vs 23.9 %) of hrHPV testing. Here we report the performance of HPV16/18 genotyping to triage the hrHPV positive participants. Methods Women aged 25 years and older received hrHPV (Hybrid Capture 2) and Papanicolaou testing; positives by either test underwent colposcopy and directed biopsy, as did a sample of double-negatives. hrHPV positive women were reflex-tested with HPV16/18 genotyping (Digene HPV Genotyping PS Test). Results Among the 8,265 participants, 10.7 % were hrHPV positive, 1.7 % had ASCUS+ cytology, 1.2 % had CIN2+; 776 (88 %) hrHPV positive women had complete results, of whom 38.8 % were positive for HPV16 (24.0 %), HPV18 (9.7 %) or both (5.1 %). CIN2+ prevalence in HPV16/18 positive women (16.3 %, 95 % CI 12.3-20.9) was twice that of HPV16/18 negative women (8.0 %, 95 % CI 5.7-10.8). HPV16/18 genotyping identified 40.5 % of CIN2, 66.7 % of CIN3 and 75.0 % of cancers. Compared to hrHPV screening alone, HPV16/18 triage significantly reduced the referral rate (10.7 % vs 3.7 %) and the number of colposcopies required to detect one CIN2+ (9 vs 6). When HPV16/18 negative women with baseline ASCUS+ cytology were also colposcopied, an additional 14 % of CIN2+ was identified; referral increased slightly to 4.2 %. Conclusions HPV16/18 triage effectively stratified hrHPV positive women by their risk of high-grade lesions. HPV16/18 positive women must be referred immediately; referral could be deferred in HPV16/18 negative women given the slower progression of non-HPV16/18 lesions, however, they will require active follow-up.
- ItemInflammatory profiles in Chilean Mapuche and non-Mapuche women with gallstones at risk of developing gallbladder cancer(2021) Jackson, Sarah S.; Van De Wyngard, Vanessa; Pfeiffer, Ruth M.; Cook, Paz; Hildesheim, Allan; Pinto, Ligia A.; Jackson, Sharon H.; Choi, Kelvin; Verdugo, Ricardo A.; Cuevas, Mara; Yanez, Cristian; Tobar-Calfucoy, Eduardo; Retamales-Ortega, Rocio; Araya, Juan Carlos; Ferreccio, Catterina; Koshiol, JillChile has high incidence rates of gallbladder cancer globally, particularly among Amerindian women, who also have a high prevalence of gallstones. We examined differences in inflammatory biomarkers between Mapuche and non-Mapuche women from the Chile Biliary Longitudinal Study, a cohort of women with ultrasound-detected gallstones. We randomly selected 200 Mapuche women frequency matched to non-Mapuche women on age and statin use Inflammatory biomarkers were analyzed using a multiplex assay and linear regression to assess associations of a priori markers (CCL20, CXCL10, IL-6, and IL-8) with ethnicity. Novel biomarkers were analyzed using exploratory factor analysis (EFA) and sufficient dimension reduction (SDR) to identify correlated marker groups, followed by linear regression to examine their association with ethnicity. The mean values of IL-8 were higher in Mapuche than non-Mapuche women (P=0.04), while CCL20, CXCL10, and IL-6 did not differ significantly by ethnicity. EFA revealed two marker groups associated with ethnicity (P=0.03 and P<0.001). SDR analysis confirmed correlation between the biomarkers and ethnicity. We found higher IL-8 levels among Mapuche than non-Mapuche women. Novel inflammatory biomarkers were correlated with ethnicity and should be studied further for their role in gallbladder disease. These findings may elucidate underlying ethnic disparities in gallstones and carcinogenesis among Amerindians.
- ItemProcessed meat consumption and associated factors in Chile: A cross-sectional study nested in the MAUCO cohort(2022) Ruedlinger, Jenny; Cid Ossandón, Vicente Salvador; Huidobro M., Andrea; Van De Wyngard, Vanessa; Vargas, Claudio; Ferreccio Readi, CatterinaProcessed meat consumption is increasing in Latin America. While in developed countries processed meat consumption has been associated with cardiovascular diseases and cancer, our region lacks data associated to its consumption and health impact. We characterized processed meat intake and associated factors in a population-based cohort of a Chilean agricultural county, MAUCO. We analyzed baseline dietary data of 7,841 participants, 4,358 women and 3,483 men (38–77 years), who answered an adapted Mediterranean index food frequency questionnaire. Eight percent of the participants presented high processed meat consumption (?5 times per week). We explored associations of processed meat consumption with participant characteristics using multinomial logistic regression models. Main factors associated with higher consumption were being men, younger and currently employed, and having a high intake (>4 times per week) of red meat (Odds ratio, 2.71, 95% CI 2.10–3.48), butter/cream (1.96, 1.60–2.41), whole-fat dairy products (1.32, 1.04–1.67) and a high intake (?1 time per day) of sugary snacks/sweets (2.49, 2.04–3.03) and sugary drinks (1.97, 1.63–2.38). Processed meat consumption associated to chronic diseases, particularly cardiovascular disease (Prevalence ratio, 2.28, 95% CI 1.58–3.29). Obesity mediated this association in a proportion of 5.0%, whereas for diabetes the proportion was 13.9%. In this population, processed meat was associated with other unhealthy dietary and lifestyle factors, as well as with chronic diseases, particularly cardiovascular disease.
- ItemSerological prevalence and persistence of high-risk human papillomavirus infection among women in Santiago, Chile(2014) Castro, Felipe A.; Dominguez, Angélica; Puschel Illanes, Klaus; Van De Wyngard, Vanessa; Snijders, Peter J.; Franceschi, Silvia; Pawlita, Michael; Ferreccio Readi, Catterina; Castro, Felipe A.; Dominguez, Angélica; Puschel Illanes, Klaus; Van De Wyngard, Vanessa; Snijders, Peter J.; Franceschi, Silvia; Pawlita, Michael; Ferreccio Readi, CatterinaAbstract Background Human papillomavirus (HPV) serology is a main factor for designing vaccination programs and surveillance strategies; nevertheless, there are few reports of HPV seroprevalence in the general population, especially in Latin America. This study aimed to describe high-risk HPV serological prevalence, persistence, and association with concurrent cervical infection, in Chilean women. Methods 1021 women from the general population, aged 15–85 years, were studied in 2001 of whom 600 were reexamined in 2006. The assessments at both time points included cervical HPV DNA testing, HPV antibody testing, cervical cytology and a sociodemographic/behavioral questionnaire. HPV DNA and antibodies against L1 protein of types 16, 18, 31, 33, 35, 45, 52, and 58 were assessed by reverse line blot and multiplex serology, respectively. Results Seropositivity was high at both baseline (43.2%) and follow-up (50.2%) and increased with age (p < 0.001); corresponding DNA prevalences were 6.7% and 8.7%. DNA and seroprevalence were associated at baseline (p = 0.01 for any HPV). Early age at first sexual intercourse and having had two or more sexual partners were independently associated with seropositivity. Most (82.0%) initially seropositive women remained seropositive at follow-up; 21.6% of initially seronegative women seroconverted, reaching 17.5% among women older than 60 years of age. ASCUS or worse cytology was correlated with HPV DNA positivity but not with HPV seropositivity. Conclusion HPV seroprevalence studies are a useful tool for learning about the dynamics of HPV infection in a community. This study contributes to understanding the natural history of HPV infection and provides a baseline assessment before the incorporation of HPV vaccination into a national program.
- ItemStatin use is not associated with inflammation among Chilean women of Mapuche and non-Mapuche ancestry with gallstones(2024) Jackson, Sarah S.; Lex, Marina; Van De Wyngard, Vanessa; Cook, Paz; Hildesheim, Allan; Pinto, Ligia A.; Jackson, Sharon H.; Choi, Kelvin; Minas, Tsion Zewdu; Morales, Hector Fabio Losada; Araya, Juan Carlos; Ferreccio, Catterina; Koshiol, Jill; Pfeiffer, Ruth M.Aim: Statins are associated with lower risk of gallstones due to anti-inflammatory effects. We assessed whether statins impact circulating inflammation among Chilean women with gallstones. Materials & methods: 200 Mapuche women were matched on statin use and age to 200 non-Mapuche women in the Chile Biliary Longitudinal Study. We analyzed 92 inflammatory biomarkers using multivariable-adjusted regression models, random forests and pathway analyses. Results: Statins were not significantly associated with any inflammation marker when women were analyzed jointly or stratified by ancestry. No significant associations were found through random forest methods and pathway analyses. Discussion: We did not find significant associations between statin use and inflammation markers in women with gallstones, suggesting that statins do not reduce inflammation once gallstones have formed.