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DOI:10.29013/ESR-24-1.2-21-25
MODERN VIEW ON THE PROBLEMS OF ACCOMPANYING THERAPY IN GYNECOLOGICAL ONCOLOGICAL PATHOLOGY. Epidemiology of gynecological oncology pathology (Review article)
Polatova Jamila Shagayratovna1, Artikkhodjaeva Guzal Shamsiddinovna 2
1 Tashkent State Dental Institute, Center for Pediatric Hematology, Oncology and Clinical Immunology
2 Tashkent State Dental Institute, Center for the Development of Professional Qualifications of Medical Workers
Cite: Polatova J. Sh., Artikkhodjaeva G. Sh. (2024). Modern View on The Problems of Accompanying Therapy in Gynecological Oncological Pathology. Epidemiology of gynecological oncology pathology (Review article). European Science Review 2024, No 1-2. https://doi.org/10.29013/ESR-24-1.2-21-25
Abstract
According to GLOBOCAN2020, cervical cancer, ovarian cancer and uterine cancer are among the ten most common cancers in women worldwide. Many studies have shown a positive correlation with age for all four types of female cancer. Due to future demographic changes, including falling parity and the aging of the baby boom generation, the average age in some countries will continue to rise. In the United States, the incidence of ovarian cancer is estimated to increase by 37%, from 20,921 cases in 2020 to 28,591 cases in 2030. Keywords: ovarian cancer, uterine cancer, female cancer
Introduction
According to the GLOBOCAN2020 project, cervical cancer, ovarian cancer and uterine cancer are among the ten most common cancers in women worldwide (FIGO Committee on Gynecologic Oncology. 2019; Amit A., Schink J., Reiss A. et al. 2011; Shepherd J. H., Spencer C., Herod J., Ind T. E., 2006). Many studies have shown a positive correlation with age for all four types of female cancer. Due to future demographic changes, including falling parity and the aging of the baby boom generation, the average age in some countries will continue to rise. In the United
States, the incidence of ovarian cancer is estimated to increase by 37%, from 20,921 cases in 2020 to 28,591 cases in 2030 (Ramirez P., Frumovitz M., Pareja R. et.al., 2018; Elliott P., Coppleson M., Russell P. et al. 2000; Whitney C. W., Sause W., Bundy B. N. et al.; Radz-insky V. E., Ordiyants I. M., Abdurakhmano-va M. B., Zhang Q. et al. 2017). This increase in ovarian cancer cases is mainly attributed to changes in age distribution and population growth (Elliott P., Coppleson M., Russell P. et al. 2000). Given the aging trend, the burden of women's cancers may continue to increase in the coming decades.
Cervical cancer in regions with a low so-cio-demographic index is the most common gynecological cancer. Relatively, ovarian cancer and uterine cancer were more common in regions with a high socio-demographic index. Female cancer causes numerous deaths worldwide and places a heavy economic burden on women and their families. With global population aging, international efforts are needed to reduce cancer incidence and mortality among women and improve women's health. Although cervical cancer can be prevented through HPV vaccination and screening for precancerous lesions, the incidence and mortality of cervical cancer in these counties is still high due to lack of necessary medical interventions (Huang H., Liu J., Li Y. et al.; Sedlis A., Bundy B. N., Rot-man M. Z. et al.; Morris M., Eifel P. J., Lu J. et al. 1999; Whitney C. W., Sause W., Bundy B. N. et al. 1999; Lanciano R. M., T. F., Martz K., Hanks G. E. 1993). Compared to cervical cancer, ovarian cancer and uterine cancer are less common worldwide (Lorus-so D., Petrelli F., Coinu A. et al. 2014; Pötter R., Haie-Meder C., van Limbergen E. et al., 2006). Overall, the incidence and mortality of the four types of cancer in women has continued to rise over recent decades.
Epidemiological patterns of cancer in women vary between regions and change over time. Systematic analyzes that comprehensively reflect trends in cancer incidence in women help policymakers measure the burden of cancer in women, build health care infrastructure, and allocate public health resources. In this cross-sectional study, we reported the incidence, mortality, and disability-adjusted life years of female breast cancer, cervical cancer, ovarian cancer, and uterine cancer from 1990 to 2019 in 204 countries. In addition, we analyzed the correlation between the morbidity or mortality rate and the sociodemographic index (Webb J. C., Key C. R., Qualls C. R. et al., 2001; Kvetnoi I., Kvetnaya T., Bocharova K. 2014).
Main part
In the Cervical Cancer Study, age-standardized incidence, mortality, and DALY rates were negatively correlated with the so-ciodemographic index. Relatively, morbidity and mortality rates were significantly higher
in these low-source countries. Carcinogenic HPV infection has been confirmed to be the main cause of cervical cancer (Maltse-va A. N. 2018; Rogovskaya S. I. 2013; Rodríguez A. C., Schiffman M., Herrero R. et al., FIGO Committee on Gynecologic Oncology. 2019; (Maltseva A. N. 2018; Rogovskaya S. I. 2013; FIGO Committee on Gynecologic Oncology. 2019). In recent decades, due to the introduction of HPV vaccination and HPV-based screening, the incidence of cervical cancer has continued to decline (FIGO Committee on Gynecologic Oncology. 2019; Radzinsky V. E., Ordiyants I. M., Abdurakhmanova M. B. 2018). Also, based on microscopic examination of cervical scraping smears, treatment of precancerous lesions is secondary prevention of cervical cancer (Orazov M. R., Radzinsky V. E., Kha-moshina M. B., Nosenko E. N., Dukhin A. O., Tokaeva E. S., Barseghyan L. K., Shkreli I., Marapov D. I., Simenel D. A., Nizhnik A. N. 2018). However, in some developing regions, such as southern sub-Saharan Africa, most women find it difficult to access effective interventions (Orazov M. R. and other 2018). Thus, it is critical to implement basic population prevention and screening programs in these regions, including the introduction of vaccination, screening for cervical cancer and precursor lesions. It is estimated that implementation of the WHO cervical cancer assessment strategy could significantly reduce cervical cancer mortality by 99% over the next century (Amit A., Schink J., Reiss A. 2011). Literature data have shown that the incidence of ovarian cancer varies depending on geographic location and is positively associated with the value of the socio-demo-graphic index. Less breastfeeding, infertility or absence of pregnancies, hormonal treatment and obesity are risk factors for ovarian cancer (Bermudez A., Bhatla N., Leung E. 2015). In contrast, oral contraceptives are a strong protective factor against ovarian cancer (Kjaer S. K., Frederiksen K., Munk C., Iftner T. 2010; Kaprin A. D., Starinsky V. V., Petrova G. V. 2019; FIGO Committee on Gynecologic Oncology. 2019).
Previous studies have shown that oral contraceptives may inhibit carcinogene-sis by interfering with estradiol production and reducing menstrual cycle estradiol ex-
posure (Usmanova E. B., Obukhova O. A., Shchelkova O. Yu. 2020; Thornquist C. 2018; Rodríguez A. C., Schiffman M., Herrero R. 2010). The high incidence of ovarian cancer in regions such as Western Europe and North America may be due to the high prevalence of these risk factors. In some developed countries, including the United States, the decline in incidence has been accompanied by a decline in mortality over the past 30 years. The development of treatment methods for ovarian cancer, including targeted therapy, neoadjuvant chemotherapy, intraperitoneal chemotherapy, and aggressive surgery, helps reduce the mortality rate of gynecological cancer (Webb J. C., Key C. R., Qualls C. R. 2001; Ramirez P., Frumovitz M., Pareja R. 2018).
Conclusion
The incidence of uterine cancer is increasing throughout the world, especially in regions with high socio-demographic index
levels. According to GBD2019, the age-standardized incidence rate of uterine cancer in the United States increased from 19.63 in 1990 to 28.80 in 2019. Obesity has been a vital risk factor contributing to the increased incidence of uterine cancer (Solopova A. G., Idrisova L. E., Vlasina A. Yu., Moskviche-va V. S. 2018; Kim H. S., Sardi J. E., Katsu-mata N. 2013; Gupta S., Maheshwari A., Parab P. 2018; Tian Zhong-ze, Li Sha, Wang Yue 2014). Women who are overweight or obese are more likely to develop uterine cancer than women of normal weight (Lorusso D., Petrelli F., Coinu A. 2014; Morley G. W., Hopkins M. P., Lindenauer S. M. 1989). In addition, decreased physical activity and a higher prevalence of diabetes are also risk factors for uterine cancer (Mabuchi S. 2016; Maltseva A. N. 2018; Wang S. 2010; Sapien-za L. G. 2018). Public health programs that help women maintain a healthy weight and increase physical activity can reduce the risk of uterine cancer.
References
FIGO Committee on Gynecologic Oncology. Revised FIGO staging for carcinoma of the cervix uteri. Int J Gynecol Obstet 2019; 145(1): 129-35.
Amit A., Schink J., Reiss A. et al. PET/CT in gynecologic cancer: present applications and future prospects - a clinician's perspective. Obstet Gynecol Clin North Am 2011; 38(1): 1-21
Shepherd J. H., Spencer C., Herod J., Ind T. E. Radical vaginal trachelectomy as a fertilitysparing procedure in women with early-stage cervical cancercumulative pregnancy rate in a series of 123 women. BJOG 2006; 113(6): 719-24.
Ramirez P., Frumovitz M., Pareja R. et.al. Phase III randomized trial of laparoscopic or robotic radical hysterectomy vs. abdominal radical hysterectomy in patients with early-stage cervical cancer: LACC Trial. N Engl J Med 2018; 379(20): 1895-904. DOI: 10.1056/ NEJMoa1806395.
Elliott P., Coppleson M., Russell P. et al. Early invasive (FIGO stage IA) carcinoma of the cervix: a clinico-pathologic study of 476 cases. Int J Gynecol Cancer 2000; 10(1): 42-52.
Whitney C. W., Sause W., Bundy B. N. et al. Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol 199; 17(50): 1339-48.
Radzinsky V. E., Ordiyants I. M., Abdurakhmanova M. B. Combination of probiotic and metabiotic in complex therapy of dysbiosis // Obstetrics and gynecology: News. Opinions. Training.-2018.- T. 6.- № 3.- С. 127-133.
Zhang Q. et al. Oncologic and obstetrical outcomes with fertility-sparing treatment of cervical cancer: a systematic review and meta-analysis // Oncotarget.2017.- Т. 8.- № 28.- С. 46580.
Huang H., Liu J., Li Y. et al. Metastasis to deep obturator and para-aortic lymph nodes in 649 patients with cervical carcinoma. Eur J Surg Oncol.
Sedlis A., Bundy B. N., Rotman M. Z. et al. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: a Gynecologic Oncology Group Study. Gynecol Oncol.
Morris M., Eifel P. J., Lu J. et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med 1999; 340(15): 1137-43.
Rydzewska L., Tierney J., Vale C. L. et al. Neoadjuvant chemotherapy plus surgery versus surgery for cervical cancer. Cochrane Database of Systematic Reviews 2012, Issue 12. Art. No.: CD007406.
Lanciano R. M., Pajak T. F., Martz K., Hanks G. E. The influence of treatment time onoutcome for squamous cell cancer of the uterine cervix treated with radiation: a patterns-of-care study. Int J Radiat Oncol Biol Phys 1993; 25(3).
Lorusso D., Petrelli F., Coinu A. et al. A systematic review comparing cisplatin and carboplatin plus paclitaxel-based chemotherapy for recurrent or metastatic cervical cancer. Gynecol Oncol 2014; 133: 117-23.
Potter R., Haie-Meder C., van Limbergen E. et al. Recommendations from gynaecological (GYN) GEC ESTRO working group (II): Concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy - 3D dose volume parameters and aspects of 3D imagebased anatomy, radiation physics, radiobiology. Radiother Oncol 2006; 78: 67-77.
Kvetnoi I., Kvetnaya T., Bocharova K. Melatonin i patologiya pozhilogo vozrasta //Vrach.-2014.- № 6.- P. 53-56.
Maltseva A. N. The use of liposomal gel coating "Flamena" in the treatment of dystrophic diseases of the vulva in women of the perimenopausal period // Modern problems of science and education.2018.
Rogovskaya S. I. Human papillomavirus prevalence and type-distribution, cervical cancer screening practices and current status of vaccination implementation in Russian Federation, the Western Countries of the former Soviet Union, Caucasus Region and Central Asia. Vaccine 2013; 31: H46-58.
FIGO Committee on Gynecologic Oncology. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynecol Obstet.
FIGO Committee on Gynecologic Oncology. Revised FIGO staging for carcinoma of the cervix uteri. Int J Gynecol Obstet 2019; 145(1): 129-35.
Радзинский В. Е., Ордиянц И. М., Абдурахманова М. Б. Комбинация пробиотика и метабиотика в комплексной терапии дисбиозов // Акушерство и гинекология: Новости. Мнения. 0бучения.2018.- T. 6.
Orazov M. R., Radzinsky V. E., Khamoshina M. B., Nosenko E. N., Dukhin A. O., Tokaeva E. S., Barseghyan L. K., Shkreli I., Marapov D. I. ., Simenel D. A., Nizhnik A. N. Vitamin D3 (cholecalciferol) and pelvic pain induced by ovarian endometriosis / / Difficult patient. 2018.- T.16.- № 4.
Kjaer S.K., Frederiksen K., Munk C., Iftner T. Long-term abcolut risk of cervical intraepithelial neoplasia grade 3 or worse following human papillomavirus infection: role of persistence. J Natl Cancer Inst 2010; 102(19): 1478-88.
Kaprin A. D., Starinsky V. V., Petrova G. V. Malignant neoplasms in Russia in 2018 (morbidity and mortality). M.: MNIOI im. P. A. Herzen - branch of the Federal State Budgetary Institution "National Medical Research Center of Radiology" of the Ministry of Health of Russia, 2019. - 250 p.
Bermudez A., Bhatla N., Leung E. FIGO cancer report 2015. Cancer of the cervix uteri. IntJ Gynecol Obstet 2015; 131: S88-95.
Usmanova E. B., Obukhova O. A., Shchelkova O. Yu. Quality of life and sexual health of patients with ovarian malignancies. Oncogynecology. 2020. № 2 (34). - P. 77-80. Doi: 10.52313/22278710_2020_2_77.
Thornquist C. The potential of dance: Reducing fashion consumption through movement therapy //Journal of Cleaner Production.2018.- Т. 183.- 824 p.
Rodriguez A. C., Schiffman M., Herrero R. et al. Longitudinal study of human
papillomavirus persistence and cervical intraepithelial neoplasia grade 2/3: critical role of duration of infection. J Natl Cancer Inst 2010; 102(5): 315-24.
Webb J. C., Key C. R., Qualls C. R. et al. Population-based study of microinvasive adenocarcinoma of the uterine cervix. Obstet Gynecol 2001; 97(5 Pt).
Solopova A.G., Idrisova L. E., Vlasina A. Yu., Moskvicheva V. S. Possibilities of restoring sexual function in women of reproductive age after treatment of endometrial cancer and borderline ovarian tumors // Doctor.2018; 29 (10): 16.
Kim H. S., Sardi J. E., Katsumata N. et al. Efficacy of neoadjuvant chemotherapy in patients with FIGO stage IB1 to IIA cervical cancer: an international collaborative meta-analysis. Eur J SurgOncol 2013; 39: 115-24.
Gupta S., Maheshwari A., Parab P. et al. Neoadjuvant chemotherapy followed by radical surgery versus concomitant chemotherapy and radiotherapy in patients with stage IB2, IIA, or IIB squamous cervical cancer: a randomized controlled trial. J Clin Oncol 2018; 36(16): 1548-55.
Tian Zhong-ze, Li Sha, Wang Yue et al. Investigation of uterine arterial chemoembolization and uterine infusion chemotherapy for advanced cervical cancer before radical radiotherapy: a long-term follow-up study. Arch Gynecol 2014.
Morley G. W., Hopkins M. P., Lindenauer S. M. et al. Pelvic exenteration, University of Michigan: 100 patients at 5 years. Obstet Gynecol 1989; 74(6): 934.
Mabuchi S et al. Chemoradiotherapy followed by consolidation chemotherapy involving paclitaxel and carboplatin and in FIGO stage IIIB/IVA cervical cancer patients./ J Gynecol Oncol. 2017 Jan;28(1): e15. Doi: 10.3802/jgo.2017. 28. e15.
Wang S et al. Efficacy of concurrent chemoradiotherapy plus adjuvant chemotherapy on advanced cervical cancer/ Chin J Cancer. 2010 Nov; 29(11): 59.
Sapienza L. G. et al. Decrease in uterine perforations with ultrasound image-guided applicator insertion in intracavitary brachytherapy for cervical cancer: A systematic review and metaanalysis //Gynecologic oncology.2018.- T. 151.
submitted 07.02.2024;
accepted for publication 25.02.2024;
published 23.03.2024
© Polatova J. Sh., Artikkhodjaeva G. Sh.
Contact: yuldashkhodjaevanigina@gmail.com