Introduction: Early detection of cervical cancer is a matter of great importance as the prognosis depends on the stage of the disease. The objective of the study consisted in the assessment of the impact of HPV self-sampling on the efficacy of populational screening programs aimed at early CC detection. Methods: The analysis was performed taking into account the Cochrane Collaboration guidelines for systematic reviews. The analyzed articles were searched for in the following databases: Medline (PubMed), Embase (Ovid), and Cochrane Library. Results: From a total of 60 citations, 16 studies were included in this review. The HPV test is highly sensitive and specific although the diagnostic accuracy of tests carried out in self-collected samples is slightly lower than that of tests carried out in samples collected by clinicians. The results of meta-analyses for HPV tests performed on self-collected samples indicate that the sensitivity for detecting CIN2+ ranges from 74% to 86% (depending on the publication and the analyzed population), and for CIN3+ from 75% to 86%. One publication showed a clearly lower sensitivity of 42% in detecting CIN3+, but the result is for a high-risk population and comes from only 1 RCT. The specificity of the assay exceeds 80% and 79.5% with regard to the detection of CIN2+ and CIN3+, respectively. As shown by the studies included in the review, both the offering of HPV self-sampling kits to patients and the mailing of such kits significantly increase the uptake of and participation in cervical cancer screening programs. In addition, self-sampling was found to be acceptable by the female subjects. Conclusions: HPV self-sampling is an innovative and cost-effective way to perform screening tests. In addition, self-sampling significantly increases the willingness to participate in screening programs among female subjects.
Cervical cancer remains a significant global health challenge, with persistent infection by oncogenic human papillomavirus (HPV) types identified as a necessary condition for its development. HPV vaccines have emerged as a crucial tool for preventing precancerous genital lesions and cervical cancer linked to specific HPV types. Over recent years, leading oncology and gynecology societies across the United States, Europe, and Australia have issued clinical guidelines aimed at optimizing the implementation of population-based HPV vaccination programs. This narrative review synthesizes key recommendations for HPV vaccination programs, focusing on guidelines published between 2019 and 2024. A total of 16 guidelines were analyzed, revealing unanimous support for vaccinating children - ideally before the age of 15 years - to ensure protection prior to sexual activity. Most recommendations emphasize the vaccination of girls and boys, with the 9-valent Gardasil 9 vaccine identified as the preferred option. A major milestone was reached in 2022, when the World Health Organization proposed a single-dose regimen as an effective strategy, offering potential benefits in public health accessibility and program efficiency. This article aims to review and compare current international guidelines for vaccination programs for human papilloma virus.
Introduction: Patient safety in long-term care is becoming an increasingly popular subject in the scientific literature. Organizational problems such as shortages of medical staff, insufficient numbers of facilities or underfunding increase the risk of adverse events, and aging populations in many countries suggests that these problems will become more and more serious with each passing year. The objective of the study is to identify interventions that can contribute to increasing patient safety in long-term care facilities. Method: A systematic review of secondary studies was conducted in accordance with the Cochrane Collaboration guidelines. Searches were conducted in Medline (via PubMed), Embase (via OVID) and Cochrane Library. The quality of the included studies was assessed using AMSTAR2. Results: Ultimately, 10 studies were included in the analysis. They concerned three main areas: promoting safety culture, reducing the level of occupational stress and burnout, and increasing the safety of medication use. Promising methods that have an impact on increasing patient safety include: preventing occupational burnout of medical staff, e.g., by using mindfulness-based interventions; preventing incidents resulting from improper administration of medications, e.g., by using structured methods of patient transfer; and the use of information technology that is more effective than the classic (paper) method or preventing nosocomial infections, e.g., through programs to improve the quality of care in institutions and the implementation of an effective infection control system. Conclusions: Taking into account the scientific evidence found and the guidelines of institutions dealing with patient safety, it is necessary for each long-term care facility to individually implement interventions aimed at continuous improvement of the quality of care and patient safety culture at the level of medical staff and management staff.
Background: Many cancer treatment methods can affect fertility by damaging the reproductive organs and glands that control fertility. Changes can be temporary or permanent. In order to preserve the fertility of cancer patients and protect the genital organs against gonadotoxicity, methods of fertility preservation are increasingly used. Considering that some patients ultimately decide not to use cryopreserved reproductive material, this review analysed the percentage of post-cancer patients using cryopreserved reproductive material, collected before treatment as part of fertility preservation. Methods: A systematic search of studies was carried out in accordance with the Cochrane Collaboration guidelines, based on a previously prepared research protocol. The search was conducted in Medline (via PubMed), Embase (via OVID), and the Cochrane Library. In addition, a manual search was performed for recommendations/clinical practice guidelines regarding fertility preservation in cancer patients. Results: Twenty-six studies met the inclusion criteria. The studies included in the review discussed the results of cryopreservation of oocytes, embryos, ovarian tissue, and semen. In 10 studies, the usage rate of cryopreserved semen ranged from 2.6% to 21.5%. In the case of cryopreserved female reproductive material, the return/usage rate ranged from 3.1% to 8.7% for oocytes, approx. 9% to 22.4% for embryos, and 6.9% to 30.3% for ovarian tissue. In studies analysing patients’ decisions about unused reproductive material, continuation of material storage was most often indicated. Recovering fertility or death of the patient were the main reasons for rejecting cryopreserved semen in the case of men. Conclusion: Fertility preservation before gonadotoxic treatment is widely recommended and increasingly used in cancer patients. The usage rate is an important indicator for monitoring the efficacy of these methods. In all of the methods described in the literature, this indicator did not exceed 31%. It is necessary to create legal and organizational solutions regulating material collection and storage and to create clear paths for its usage in the future, including by other recipients.
Purpose of review: Type 2 diabetes mellitus (T2DM) is a chronic disease that may lead to severe complications. The main methods of preventing or delaying the onset of T2DM include lifestyle changes. The purpose of this study is to identify and evaluate the effectiveness of workplace interventions aimed at preventing type 2 diabetes. An umbrella review was conducted in accordance with the Cochrane Collaboration guidelines. Searches were performed in Medline (via PubMed), Embase (via OVID), and Cochrane Library databases. The quality assessment of the included studies was performed using the AMSTAR2 tool. Recent findings: The final analysis included 7 studies. The majority (4 of 7) of the studies included in the review focused on workplace interventions based on the guidelines of the US Diabetes Prevention Program (DPP) or other similar programs. The method of decreasing the risk of type 2 diabetes among employees are programs consisting of multiple approaches aimed at improving parameters associated with diabetes, i.e., body weight, and therefore BMI, reduction, and reducing blood glucose levels, as well as HbA1c levels through educational approach and lifestyle changes. The results of those studies point to multicomponent interventions as more effective than single-component interventions. Summary: An effective workplace intervention aimed to reduce the risk of type 2 diabetes among employees is a multicomponent program consisting of elements such as educational activities, interventions targeting dietary changes and increased physical activity.
Background/Objectives: Human papillomavirus (HPV) vaccination programs play a critical role in the primary prevention of HPV-related diseases, including cervical cancer. However, the principles governing the implementation of these programs vary across European Union (EU) countries. The objective of this study was to analyze and compare the strategies for implementing HPV vaccination programs across the EU, with a focus on access, vaccine selection, and procurement processes. Methods: This study utilized a comprehensive review of official websites from government bodies, public health organizations, and dedicated vaccination platforms in each of the 27 EU member states. Additionally, a search of Tenders Electronic Daily (TED) was conducted to examine the criteria used in tendering processes for vaccine suppliers involved in national HPV vaccination programs. Results: All 27 EU countries provide public funding for HPV vaccination, with 26 countries offering free vaccination for both girls and boys. In 22 of these countries, the nine-valent HPV vaccine is the only option available for free under national programs. Estonia and Ireland are exceptions, where a single dose of Gardasil 9 is administered. Most countries adhere to the approved vaccination schedules, though slight variations exist. The predominant criterion for selecting vaccine suppliers in national tenders is the lowest price offered. Conclusions: HPV vaccination programs across the EU are uniformly funded through public health systems, yet access to free vaccination and specific program details vary by country. These variations reflect the diverse healthcare systems and procurement strategies in place, which can impact the systemic approach to HPV prevention. Further harmonization of vaccine procurement and implementation strategies may enhance the effectiveness and equity of HPV vaccination across Europe.