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Article ; Online: Cervical screening in women over 65. PRO: Are we asking the right question?

Elit, Laurie

2016 Volume 142, Issue 3, Page(s) 381–382

MeSH term(s)	Case-Control Studies ; Early Detection of Cancer ; Female ; Humans ; Mass Screening ; Medicare ; United States ; Uterine Cervical Neoplasms
Language	English
Publishing date	2016-08-12
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	801461-9
ISSN	1095-6859 ; 0090-8258
ISSN (online)	1095-6859
ISSN	0090-8258
DOI	10.1016/j.ygyno.2016.08.230
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Article ; Online: Wait times from diagnosis to treatment in cancer.

Elit, Laurie

Journal of gynecologic oncology

2015 Volume 26, Issue 4, Page(s) 246–248

MeSH term(s)	Female ; Humans ; Hysterectomy/methods ; Time-to-Treatment ; Uterine Cervical Neoplasms/surgery
Language	English
Publishing date	2015-10
Publishing country	Korea (South)
Document type	Comment ; Editorial
ZDB-ID	2478405-9
ISSN	2005-0399 ; 2005-0380
ISSN (online)	2005-0399
ISSN	2005-0380
DOI	10.3802/jgo.2015.26.4.246
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Zs.A 6484: Show issues

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Article ; Online: Cervical cancer in the older woman.

Elit, Laurie

Maturitas

2014 Volume 78, Issue 3, Page(s) 160–167

Abstract: Objectives: (1) To understand whether women who are older when diagnosed with cervical cancer have a poorer survival compared to those younger, and if so, to determine the relative importance of patient, tumor and treatment factors. (2) To review ... ...

Abstract	Objectives: (1) To understand whether women who are older when diagnosed with cervical cancer have a poorer survival compared to those younger, and if so, to determine the relative importance of patient, tumor and treatment factors. (2) To review whether older women are candidates for aggressive curative treatment for their cervical cancer and the age related effectiveness and toxicity. Methods: A review of the published English literature from 1990 to 2014 using search terms related to cervical cancer and older age was conducted. Results: A number of confounders may influence whether advanced age impacts survival such as patient comorbidities, stage, histology, grade, no or incomplete treatment, less radical surgery, palliative rather than curative treatment, lack of adjuvant radiation after surgery, lower rates of chemotherapy and others. When older women are treated as aggressively as their younger counterparts, survival is the same; however, especially where radiation or chemotherapy is used, toxicities may occur at the same or slightly higher rate. Conclusions: The more recent population based studies have larger sample sizes and minimize the biases seen in single center studies. They have also corrected for confounders giving a more accurate answer concerning the outcomes of older women treated for cervical cancer. Performance status (or "frailty") and not chronologic age should define the optimal treatment strategy for older women with cervical cancer. Treatment related toxicities can be managed with treatment breaks or dose reductions. For those who receive curative treatment, the outcomes appear similar regardless of age.
MeSH term(s)	Age Factors ; Aged ; Antineoplastic Agents/toxicity ; Cervix Uteri/pathology ; Female ; Humans ; Survival Rate ; Uterine Cervical Neoplasms/therapy
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2014-07
Publishing country	Ireland
Document type	Comparative Study ; Journal Article ; Review
ZDB-ID	80460-5
ISSN	1873-4111 ; 0378-5122
ISSN (online)	1873-4111
ISSN	0378-5122
DOI	10.1016/j.maturitas.2014.04.018
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Zs.A 1432: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 575: Show issues

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Article ; Online: Role of cervical screening in older women.

Elit, Laurie

Maturitas

2014 Volume 79, Issue 4, Page(s) 413–420

Abstract: Objective: To review the literature concerning the role of cervical screening in women 60 years and older.: Methods: Literature review was conducted using PubMed and the search terms cervical neoplasm, cancer, middle aged, elderly, aged, ... ...

Abstract	Objective: To review the literature concerning the role of cervical screening in women 60 years and older. Methods: Literature review was conducted using PubMed and the search terms cervical neoplasm, cancer, middle aged, elderly, aged, postmenopausal, cervical cytology and screening. To be included in the review, the article must have been in the English language. The search focused on publications from 2000 forward. Results: The case control and modeling studies that addressed the role of cervical cytology screening in women 60 and older were reviewed. The outcomes of interest included: (1) the benefits of screening in terms of decrease rate of cervical cancer incidence (6 studies) and mortality (3 studies); (2) the duration of protection of the last screening test (4 studies); and (3) the harms of screening older women including false positive test results and cost. Conclusions: Cervical cytology screening is beneficial for women over 60 years in terms of preventing the occurrence and death from cervical cancer. A negative cytology test appears to have 5 years of protection in this age group. Age of last screen with in an organized screening program may differ compared to the goals and wishes of individual women.
MeSH term(s)	Aged ; Aged, 80 and over ; Early Detection of Cancer ; Female ; Health Services for the Aged ; Humans ; Middle Aged ; Uterine Cervical Neoplasms/prevention & control ; Vaginal Smears/utilization ; Women's Health
Language	English
Publishing date	2014-12
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	80460-5
ISSN	1873-4111 ; 0378-5122
ISSN (online)	1873-4111
ISSN	0378-5122
DOI	10.1016/j.maturitas.2014.09.012
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Zs.A 1432: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 575: Show issues

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Article ; Online: Perceptions of Cancer in Parents of Adolescent Daughters in Northwest Cameroon.

Elit, Laurie / Tum, Eric M / Ngalla, Calvin / Fungchwi, Glenn M / Fokom Domgue, Joel / Nouvet, Elysee

Current oncology (Toronto, Ont.)

2023 Volume 30, Issue 8, Page(s) 7167–7177

Abstract: Background: Cancer is a rapidly rising cause of morbidity and mortality in sub-Saharan Africa. Cervical cancer, in particular, is still one of the leading causes of mortality for women in this setting. The uptake of healthcare services is in part ... ...

Abstract	Background: Cancer is a rapidly rising cause of morbidity and mortality in sub-Saharan Africa. Cervical cancer, in particular, is still one of the leading causes of mortality for women in this setting. The uptake of healthcare services is in part influenced by patients' belief systems. We sought to better understand the perception of cancer in the Kom tribe of Northwest Cameroon. Methods: A qualitative research study was completed using a semi-structured interview guide and one-on-one interviews with 45 parents of girls aged 9-14 years. These girls were candidates for free HPV vaccination to prevent cervical cancer. The interviews were recorded, transcribed, and analyzed using ATLAS.ti 9. Results: Thirty-five mothers and ten fathers with a median age of 42 yo were interviewed from Mbingo, Belo, Njinikom, and Fundong. Half of the parents were farmers, with three being herbalists or traditional medicine doctors. Seventy-seven percent had either no or only primary school education. None had had cancer. All knew at least one person with cancer. The most common word for cancer in the Kom language is " Conclusion: Ways to bridge biomedical healthcare services and traditional medicine are needed, especially in tribal contexts where the latter is an integral part of daily life.
MeSH term(s)	Humans ; Adolescent ; Female ; Nuclear Family ; Uterine Cervical Neoplasms ; Cameroon ; Parents
Language	English
Publishing date	2023-07-25
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol30080519
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Zs.A 4305: Show issues

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Article: Role of professional societies in the global battle against gynecologic cancers.

Elit, L

European journal of gynaecological oncology

2010 Volume 30, Issue 6, Page(s) 605–608

MeSH term(s)	Diffusion of Innovation ; Female ; Genital Neoplasms, Female/prevention & control ; Healthcare Disparities ; Humans ; Societies, Medical
Language	English
Publishing date	2010-01-21
Publishing country	China
Document type	Journal Article
ZDB-ID	604589-3
ISSN	0392-2936
ISSN	0392-2936
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Zs.A 1679: Show issues

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Article ; Online: Evaluating equity of access and predictors of minimally invasive hysterectomy for endometrial and cervical cancer from 2000 to 2017 in Ontario, Canada: A population-based cohort study.

McGinnis, Justin M / Pond, Gregory R / Reade, Clare J / Schnarr, Kara L / Simunovic, Marko / Elit, Lorraine M / Seow, Hsien-Yeang / Helpman, Limor

Journal of surgical oncology

2023 Volume 129, Issue 2, Page(s) 392–402

Abstract: Introduction: We sought to assess the uptake of minimally invasive hysterectomy among patients with endometrial and cervical cancer in Ontario, Canada, and assess the equity of access to minimally invasive surgery (MIS) by evaluating associations with ... ...

Abstract	Introduction: We sought to assess the uptake of minimally invasive hysterectomy among patients with endometrial and cervical cancer in Ontario, Canada, and assess the equity of access to minimally invasive surgery (MIS) by evaluating associations with patient, disease, institutional, and provider factors. Methods: This is a retrospective population-based cohort study of hysterectomy for endometrial and cervical cancer in Ontario (2000-2017). Surgical approach, clinicopathologic, sociodemographic, institutional, and provider factors were identified through administrative databases. Fisher's exact, χ Results: A total of 27 652 patients were included. In total, 6199/24 264 (26%) endometrial and 842/3388 (25%) cervical cancer patients received MIS. The proportion of MIS to open surgeries increased from <0.1% in 2000 to over 55% in 2017 (odds ratio [OR] = 1.31, confidence interval [CI] = 1.28-1.34). Low-income quintile, rurality, low hospital volume, nonacademic hospital, nongynecologic oncology surgeon, and earlier year of surgeon graduation were associated with reduced odds of MIS (OR < 1). Conclusions: The uptake of MIS hysterectomy increased steadily over the time period. Receipt of MIS is dependent upon multiple social determinants, provider variables, and systems factors. These disparities raise concern for health equity in Ontario and have significant implications for health systems planning and resource allocation.
MeSH term(s)	Female ; Humans ; Uterine Cervical Neoplasms/surgery ; Uterine Cervical Neoplasms/pathology ; Retrospective Studies ; Ontario/epidemiology ; Cohort Studies ; Hysterectomy ; Health Services Accessibility ; Minimally Invasive Surgical Procedures ; Neoplasm Staging
Language	English
Publishing date	2023-09-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.27461
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Article ; Online: Assessing knowledge, attitudes and belief toward HPV vaccination of parents with children aged 9-14 years in rural communities of Northwest Cameroon: a qualitative study.

Elit, Lorraine / Ngalla, Calvin / Afugchwi, Glen Mbah / Tum, Eric / Fokom Domgue, Joel / Nouvet, Elysée

BMJ open

2022 Volume 12, Issue 11, Page(s) e068212

Abstract: Background: Human papilloma virus (HPV) vaccination is essential for the WHO cervical cancer elimination initiative. In Cameroon, HPV vaccine uptake is currently 5%. To assess the knowledge, beliefs and attitudes of parents of young girls aged 9-14 ... ...

Abstract	Background: Human papilloma virus (HPV) vaccination is essential for the WHO cervical cancer elimination initiative. In Cameroon, HPV vaccine uptake is currently 5%. To assess the knowledge, beliefs and attitudes of parents of young girls aged 9-14 years about HPV vaccines within rural communities in the Northwest Region of Cameroon. Methods: During January-May 2022, we conducted 45 one-on-one interviews using a semistructured interview guide in the localities of Mbingo, Njinikom and Fundong. Participants were parents of girls aged 9-14 years who speak English or Pidgin English. Healthcare workers were excluded. The interviews were recorded, transcribed and analysed using ATLAS.ti V.9. Member checking was conducted presenting our findings and getting feedback from a focus group of parents. Results: Thirty-five mothers and 10 fathers were interviewed with a mean age of 42 years. Ninety-one per cent of parents had ever been vaccinated. Seventy-seven per cent had no or only primary school education. Thirty-two parents (71.12%) had daughters who had not been vaccinated against HPV. The themes identified include: perceived effectiveness of the HPV vaccine, affective behaviour (how they feel about the vaccine), accessibility (ability to get the vaccine), intervention coherence, ethicality (including parental informed consent), opportunity cost (future potential financial implications of cancer prevention), decision-making in the home (predominantly paternalistic), self-efficacy (extent to which education initiatives were effective) and quality initiatives (use of village infrastructure including fons/qwifons, village crier, healthcare worker presenting at the njangi house, schools and churches). Member checking with 30 women from two other communities confirmed our findings. Conclusions: Lack of awareness concerning the availability and purpose of the HPV vaccination was prevalent. Use of mainstream media and top-down health education activities are not effective. Novel approaches should engage local community health workers and use established community social and leadership structures. Trial registration number: ClinicalTrials.gov Registry (NCT05325138).
MeSH term(s)	Adult ; Child ; Female ; Humans ; Cameroon ; Health Knowledge, Attitudes, Practice ; Papillomavirus Infections/prevention & control ; Papillomavirus Infections/psychology ; Papillomavirus Vaccines ; Parents/psychology ; Patient Acceptance of Health Care/psychology ; Rural Population ; Uterine Cervical Neoplasms/prevention & control ; Vaccination/psychology ; Adolescent
Chemical Substances	Papillomavirus Vaccines
Language	English
Publishing date	2022-11-15
Publishing country	England
Document type	Clinical Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-068212
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Article ; Online: Study protocol for assessing knowledge, attitudes and belief towards HPV vaccination of parents with children aged 9-14 years in rural communities of North West Cameroon: a qualitative study.

Elit, Lorraine / Ngalla, Calvin / Afugchwi, Glen Mbah / Tum, Eric / Fokom-Domgue, Joël / Nouvet, Elysée

BMJ open

2022 Volume 12, Issue 8, Page(s) e062556

Abstract: Introduction: Despite human papilloma virus (HPV) vaccine being incorporated in the National Immunisation Programme in Cameroon in 2019, HPV vaccine uptake among eligible girls has been poor (5%). The barriers to HPV vaccination in this high-burden ... ...

Abstract	Introduction: Despite human papilloma virus (HPV) vaccine being incorporated in the National Immunisation Programme in Cameroon in 2019, HPV vaccine uptake among eligible girls has been poor (5%). The barriers to HPV vaccination in this high-burden setting have not been previously studied, especially in rural areas. We propose to evaluate the knowledge, attitudes and beliefs of parents of girls aged 9-14 years regarding HPV vaccine. Methods and analysis: Study design Ethics and dissemination: Ethics Trial registration number: NCT05325138.
MeSH term(s)	Adolescent ; Cameroon ; Child ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Papillomavirus Infections/prevention & control ; Papillomavirus Vaccines ; Parents ; Patient Acceptance of Health Care ; Qualitative Research ; Rural Population ; Vaccination
Chemical Substances	Papillomavirus Vaccines
Language	English
Publishing date	2022-08-24
Publishing country	England
Document type	Clinical Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-062556
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Article ; Online: The impact of preoperative imaging on wait times, surgical approach and overall survival in endometrioid endometrial cancers.

Schnarr, Kara L / Seow, Hsien / Pond, Gregory R / Helpman, Limor / Elit, Lorraine M / O'Leary, Erin / Kong, Iwa

Gynecologic oncology

2022 Volume 165, Issue 2, Page(s) 317–322

Abstract: Objectives: Routine preoperative axial imaging studies (CT/MRI) are not recommended for endometrioid endometrial cancer as they are unlikely to change management and may delay surgery. This study evaluated the association of receiving preoperative ... ...

Abstract	Objectives: Routine preoperative axial imaging studies (CT/MRI) are not recommended for endometrioid endometrial cancer as they are unlikely to change management and may delay surgery. This study evaluated the association of receiving preoperative imaging on various outcomes. Methods: A population-based cohort of Endometrioid Endometrial Cancer cases from 2006 to 2016 were identified from the Cancer Registry in Ontario, Canada. Wait time to surgery, type of surgery and overall survival were evaluated in patients with and without preoperative imaging. Predictive factors for wait time > 56 days and aggressive surgery (radical hysterectomy / lymphadenectomy) were determined using multivariable regression analysis. Results: 13,050 cases were included. 22.6% of patients received preoperative imaging, mainly CT scans. Most patients (95.9%) received no neoadjuvant treatment. Patients with preoperative imaging were more likely to have neoadjuvant treatment (11.7% vs. 1.8%) and less likely to have surgery at 180 days post diagnosis (87.9% vs 94.6%). Patients with preoperative imaging had median wait time to surgery of 64 days (47-87), compared to 53 days (36-74) than those without imaging (p < 0.001). Multivariable modeling showed preoperative imaging was associated with decreased odds of having surgery within 56 days (OR = 0.68, 95% CI = 0.62-0.75), and increased odds (OR = 1.73, 95% CI = 1.53-1.95) of having aggressive surgery. The 5-year overall survival for patients with imaging was 84.8% versus 91.1% for patients without preoperative imaging. Conclusions: Preoperative imaging was associated with longer wait times to surgery, more aggressive surgery, surgery with a gynecologic oncologist and increased use of neoadjuvant and adjuvant treatment. In early-stage disease there was no observed improvement in overall survival for patients with preoperative imaging. Further research on potential benefits of preoperative imaging in higher risk patients is required.
MeSH term(s)	Carcinoma, Endometrioid/diagnostic imaging ; Carcinoma, Endometrioid/surgery ; Endometrial Neoplasms/diagnostic imaging ; Endometrial Neoplasms/surgery ; Female ; Humans ; Hysterectomy ; Neoadjuvant Therapy ; Neoplasm Staging ; Ontario/epidemiology ; Operative Time ; Retrospective Studies ; Tomography, X-Ray Computed
Language	English
Publishing date	2022-03-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	801461-9
ISSN	1095-6859 ; 0090-8258
ISSN (online)	1095-6859
ISSN	0090-8258
DOI	10.1016/j.ygyno.2022.02.019
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