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Zhonghua Liu Xing Bing Xue Za Zhi =... Oct 2021To systematically summarize and assess risk prediction models for occurrence of cervical cancer and to provide evidence for selecting the most reliable model for...
To systematically summarize and assess risk prediction models for occurrence of cervical cancer and to provide evidence for selecting the most reliable model for practice, and guide cervical cancer screening. Two groups of keywords related to cervical cancer and risk prediction model were searched on Chinese databases (CNKI, and Wanfang) and English databases (PubMed, Embase, and Cochrane Library). Original articles that developed or validated risk prediction models and published before November 21, 2019, were selected. Information form was created based on the CHARMS checklist. The PROBAST was used to assess the risk of bias. 12 eligible articles were identified, describing 15 prediction models, of which five were established in China. The predicted outcomes included multiple stages from cervical precancerous lesions to cancer occurrence, ., abnormal Pap smear (1), occurrence or recurrence of CIN (9), and occurrence of cervical cancer (5), . The most frequently used predictors were HPV infection (12), age (7), smoking (5), and education (5). There were two models using machine learning to develop models. In terms of model performance, the discrimination ranged from 0.53 to 0.87, while only two models assessed the calibration correctly. Only two models were externally validated in Taiwan of China, using people in different periods. All of the models were at high risk of bias, especially in the analysis domain. The problems were concentrated in the improper handling of missing data (13), preliminary evaluation of model performance (13), improper use of internal validation (12), and insufficient sample size (11). In addition, the problems of inconsistency measurements of predictors and outcomes (8) and the flawed report of the use of blindness for outcome measures (8) were also severe. Compared with the other models, the Rothberg (2018) model had relatively high quality. There are a certain number of cervical cancer risk prediction models, but the quality is poor. It is urgent to improve the measurement of predictors and outcomes, the statistical analysis details such as handling missing data and evaluation of model performance and externally validate existing models to better guide screening.
Topics: Bias; Early Detection of Cancer; Female; Humans; Prognosis; Risk; Uterine Cervical Neoplasms
PubMed: 34814624
DOI: 10.3760/cma.j.cn112338-20200806-01031 -
Preventive Medicine Jun 2020Cervical cancer mortality in the United Kingdom (UK) has decreased over the last decade, largely due to uptake of cervical cancer screening. However, only those with a...
Cervical cancer mortality in the United Kingdom (UK) has decreased over the last decade, largely due to uptake of cervical cancer screening. However, only those with a female gender marker on their health records are invited, creating a significant barrier to gender minorities accessing screening. We undertook a systematic review to synthesise published literature on cervical cancer screening among eligible gender minorities, aiming to identify barriers and facilitators that might inform changes in UK policy and clinical practice. We conducted a broad search across Medline, Embase, PsycInfo and Global Health databases to 3rd January 2020 and included any original, peer-reviewed research, published in the English language that reported on cervical cancer screening among gender minorities assigned female at birth (AFAB). Twenty-seven studies were critically appraised and included in the final synthesis, which identified significant disparities in cervical cancer screening uptake between gender minorities AFAB and cis women. It revealed a lack of knowledge surrounding the relationship between gender minority status and cervical cancer risk among both service users and providers and highlighted significant barriers to access for gender minorities AFAB. Cervical cancer screening was not universally associated with dysphoria among gender minorities AFAB and we recommend that providers explore patients' preferences around screening, while avoiding assumptions. Providers should be proficient in examination techniques that maximise patient autonomy and minimise gender dysphoria or pain. Self-swabs for high-risk HPV may provide a more acceptable, evidence-based, alternative to Pap smears but there remains a need for further UK-specific research, to inform changes in policy.
Topics: Early Detection of Cancer; Female; Healthcare Disparities; Humans; Male; Papanicolaou Test; Sexual and Gender Minorities; United Kingdom; Uterine Cervical Neoplasms
PubMed: 32243938
DOI: 10.1016/j.ypmed.2020.106071 -
Journal of Women's Health (2002) Dec 2019Incarcerated women often access health care primarily through contact with correctional systems. Cervical cancer screening within the correctional system can address...
Incarcerated women often access health care primarily through contact with correctional systems. Cervical cancer screening within the correctional system can address the preventable outcome of cervical dysplasia and cancer in this high-risk population. A search of PubMed, EMBASE, CINAHL, and ClinicalTrials.gov was conducted for articles published between January, 1966 and December, 2018. All studies on a population of jailed or incarcerated females and at least one of the following outcomes: cervical cancer or dysplasia, pap smear screening, knowledge about screening, treatment of cervical dysplasia, and compliance with follow-up were analyzed. Forty-two studies met inclusion criteria. All 21 studies with prevalence outcomes described a higher prevalence of cervical dysplasia and cancer in the women involved with corrections, compared to a variety of different sources that served as community control groups. The data on screening outcomes were inconsistent. Follow-up compliance for abnormal results was poor, with a study finding that only 21% of women were rescreened within 6 months of the recommended time period. Knowledge about cervical cancer and screening was evaluated in eight studies and was poor across all studies. Women involved in correctional systems have a higher prevalence of cervical dysplasia and cancer than women in the general population. Acceptance of screening varies, and no published interventions have been shown to improve screening within the prison system. Treatment and compliance with follow-up recommendations are extremely poor and should be a focus of future research.
Topics: Early Detection of Cancer; Female; Humans; Mass Screening; Papanicolaou Test; Prevalence; Prisoners; Prisons; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 30939063
DOI: 10.1089/jwh.2018.7440 -
International Journal of Gynaecology... May 2020Human papillomavirus (HPV) testing may be feasible for primary cervical cancer screening in low-resource countries.
BACKGROUND
Human papillomavirus (HPV) testing may be feasible for primary cervical cancer screening in low-resource countries.
OBJECTIVE
To compare self-sampling by women with clinician-performed sampling for HPV testing in Africa.
SEARCH STRATEGY
MEDLINE, Google scholar, EMBASE, and several journals were searched from 2000 until 2015 using relevant terms.
SELECTION CRITERIA
Selected studies compared self-sampled and clinician-sampled HPV tests.
DATA COLLECTION AND ANALYSIS
Data extraction forms included description of the type of HPV screening, description of any additional intervention components, study design, sample size, follow-up periods, analytic approach, reported numerical outcomes, results, and limitations.
RESULTS
Twenty-five studies were identified. Women of a wide age range were successful at self-sampling in many African countries. More than 95% of self-samples yielded HPV DNA results. The concordance in test results between self-collected samples and clinician-collected samples was reasonably high in most studies. In all studies, the quality of cytology from self-sampling matched that of clinician-sampling. Women were generally positive about self-collection, but noted some concerns.
CONCLUSION
Self-sampling for HPV DNA testing seems to represent a feasible alternative to the Pap test. Further research is needed to provide a solid evidence base to inform using of self-sampling for HPV DNA testing for primary cervical cancer screening.
Topics: Adult; Africa; Early Detection of Cancer; Female; Humans; Mass Screening; Papillomaviridae; Papillomavirus Infections; Randomized Controlled Trials as Topic; Self Care; Specimen Handling; Uterine Cervical Neoplasms
PubMed: 32037532
DOI: 10.1002/ijgo.13112 -
Journal of Education and Health... 2020Pap smear test is one of the most important actions in preventing cervical cancer. This study aimed to perform a meta-analysis on all related literature about the...
CONTEXT
Pap smear test is one of the most important actions in preventing cervical cancer. This study aimed to perform a meta-analysis on all related literature about the effects of health belief model (HBM)-based training on Pap smear screening test performance of Iranian women.
METHODS
The search was performed in Scopus, PubMed, and Web of Science. Eligibility criteria were limited to English and Persian language articles with experimental or semi-experimental methods until October 2019 that evaluated the effect of HBM-based training on Iranian women's performance of Pap smear test. We excluded studies that used both cervical and breast cancer screening together.
RESULTS
Twelve studies were performed on totally 1605 participants. This meta-analysis showed that all of Health Belief Model (HBM) constructs improved significantly among HBM-based trained women, perceived susceptibility (standard mean division [SMD] =0.785; = 0.002; confidence interval [CI] = 0.005 to 1.56; Heterogeneity; = 0.013; = 97%)., perceived severity (SMD = 1.14; = 0.001; CI = 0.66-1.62; heterogeneity; < 0.001; = 92%), perceived benefits (SMD = 1.25; = 0.001; CI = 0.545-0.135 heterogeneity; = 0.003; = 97%), perceived barrier (SMD = 0.20; = 0.001; CI = 0.44-1.24; heterogeneity; < 0.001; = 92%) and perceived self-efficacy (SMD = 0.638; < 0.001; CI =1.76-0.426; heterogeneity; < 0.001; = 97%).
CONCLUSION
Cervical screening education program based on the HBM can be effective on Iranian women's performance in their perceived susceptibility, perceived severity, perceived barrier, and perceived self-efficacy about Pap smear test.
PubMed: 32953907
DOI: 10.4103/jehp.jehp_684_19 -
Acta Cytologica 2023The WHO Reporting System for Pancreaticobiliary Cytopathology revised the Papanicolaou Society of Cytopathology guidelines in alignment with the WHO classification of... (Meta-Analysis)
Meta-Analysis
Diagnostic Performance of Bile Duct Brush Cytology with Risk of Malignancy of Standardized Categories in the Wake of World Health Organization Reporting System for Pancreaticobiliary Cytopathology: An Updated Systematic Review and Meta-Analysis.
INTRODUCTION
The WHO Reporting System for Pancreaticobiliary Cytopathology revised the Papanicolaou Society of Cytopathology guidelines in alignment with the WHO classification of digestive system tumors, 5th edition. The current systematic review and meta-analysis have been conducted to accurately assess the performance of bile duct brush cytology and report the risk of malignancy (ROM) of each standard category by following the guidelines of diagnostic test accuracy meta-analysis.
METHODS
Medline/Pubmed and Cochrane databases were searched till June 8, 2023, with a strategy that included target site (pancreaticobiliary and related terms), diagnostic method (bile duct brushing and related terms), and keywords for diagnostic performance (for Cochrane database). Inclusion criteria included studies that have assessed bile duct cytology (BDC) for pancreaticobiliary duct stricture with a sample size of over 50, provided cytological diagnoses similar to the WHO system with details to deduce true positives, true negatives, false positives, and false negatives through subsequent final diagnoses (benign vs. malignant). The exclusion criteria were the fewer sample size, assessment through other cytological categories, limited data, and clinical setting. Two authors independently reviewed the result of the search strategy. The quality of the selected articles was assessed by the QUADAS-2 tool. Bivariate random-effects model was used to get the pooled sensitivity and specificity. Heterogeneity across studies was assessed using I-squared statistics, and potential sources were found using meta-regression. Pooled and a range of ROM in each category was analyzed.
RESULTS
Thirteen studies were included with 4,398 bile duct brushings. The pooled sensitivity is 0.437 (95% CI: 0.371-0.504), and the pooled specificity is 0.972 (95% CI: 0.943-0.987). The ROM in various categories are as follows: inadequate/nondiagnostic: 23-100% (pooled: 50.15%), benign/negative for malignancy: 22-70% (38%), atypical: 0-95% (66%), suspicious for malignancy: 74-100% (89%), malignant: 91-100% (98%).
CONCLUSION
Even with standard cytological categories, the sensitivity of BDC remains low. The review has analyzed and discussed potential causes of heterogeneity that will be helpful for future diagnostic studies.
Topics: Humans; Bile Ducts; Cytodiagnosis; Bile Duct Neoplasms; Pancreatic Neoplasms; Sensitivity and Specificity
PubMed: 37879315
DOI: 10.1159/000534764 -
Preventive Medicine Sep 2018The purpose of this project was to assess the magnitude of the relationship between violence against women and cancer; to identify the exposures and cancers for which... (Meta-Analysis)
Meta-Analysis
The purpose of this project was to assess the magnitude of the relationship between violence against women and cancer; to identify the exposures and cancers for which this relationship was particularly robust; to identify the effect of violence exposure on cancer screening. We conducted a meta-analysis of 36 studies to determine the relationship between violence against women and cancer outcomes, including screening, in 2017. Results from this review provide evidence of a significant, positive relationship between violence and cancer diagnoses, particularly for cervical cancer. Women who were victims of intimate partner violence and sexual abuse were more likely to be diagnosed with cancer compared with non-victims. Violence against women did not appear to be related to cancer screening practices and routine clinical service utilization; however, violence was associated with greater odds of abnormal pap test results. Victims of intimate partner violence and women who suffered physical abuse were more likely to have abnormal pap test results. In conclusion, use of screening tools for violence against women in clinical settings may improve the breadth and quality of research on violence against women and cancer. Investigators should consider how to creatively apply case-control and retrospective cohort designs to investigate the complex mechanisms and moderators of the relationship between violence against women and cancer.
Topics: Adult; Female; Humans; Intimate Partner Violence; Mass Screening; Papanicolaou Test; Uterine Cervical Neoplasms; Young Adult
PubMed: 29981792
DOI: 10.1016/j.ypmed.2018.07.008 -
Systematic Reviews Nov 2018There is scanty or inconclusive evidence on which cervical cancer screening tool is effective and suitable for human immunodeficiency virus (HIV)-seropositive women. The...
BACKGROUND
There is scanty or inconclusive evidence on which cervical cancer screening tool is effective and suitable for human immunodeficiency virus (HIV)-seropositive women. The aim of this review was to assess, synthesise and document published evidence relating to the available cervical cancer screening modalities for HIV-seropositive women in developing countries. This paper did not review the issue of human papillomavirus (HPV) prophylactic vaccine on HIV-seropositive women.
METHODS
Five electronic databases were systematically searched from inception to January 2018 for relevant published original research examining cervical cancer prevention modalities for HPV infection, abnormal cytology and direct visualisation of the cervix amongst HIV-seropositive women in developing countries. Extra studies were identified through reference list and citation tracking.
RESULTS
Due to methodological and clinical heterogeneity, a narrative synthesis was presented. Of the 2559 articles, 149 underwent full-text screening and 25 were included in the review. Included studies were of moderate quality, and no exclusions were made based on quality or bias. There is no standard cervical cancer screening test or programme for HIV-seropositive women and countries screening according to available resources and expertise. The screening methods used for HIV-seropositive women are the same for HIV-negative women, with varying clinical performance and accuracy. The main cervical cancer screening methods described for HIV-seropositive women are HPV deoxyribonucleic acid/messenger RNA (DNA/mRNA) testing (n = 16, 64.0%), visual inspection with acetic acid (VIA) (n = 13, 52.0%) and Pap smear (n = 11, 44.0%). HPV testing has a better accuracy/efficiency than other methods with a sensitivity of 80.0-97.0% and specificity of 51.0-78.0%. Sequential screening using VIA or visual inspection with Lugol's iodine (VILI) and HPV testing has shown better clinical performance in screening HIV-seropositive women.
CONCLUSION
Although cervical cancer screening exists in almost all developing countries, what is missing is both opportunistic and systematic organised population-based screenings. Cervical cancer screening programmes need to be integrated into already existing HIV services to enable early detection and treatment. There is a need to offer opportunistic and coordinated screening programmes that are provider-initiated to promote early identification of cervical precancerous lesions.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42018095702.
Topics: Adult; Developing Countries; Early Detection of Cancer; Female; HIV Seropositivity; Human Papillomavirus DNA Tests; Humans; Papillomaviridae; Papillomavirus Infections; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 30447695
DOI: 10.1186/s13643-018-0874-7 -
Preventive Medicine Nov 2018Primary screening for cervical cancer is transitioning from the longstanding Pap smear towards implementation of an HPV-DNA test, which is more sensitive than Pap...
Primary screening for cervical cancer is transitioning from the longstanding Pap smear towards implementation of an HPV-DNA test, which is more sensitive than Pap cytology in detecting high-risk lesions and offers greater protection against invasive cervical carcinomas. Based on these results, many countries are recommending and implementing HPV testing-based screening programs. Understanding what factors (e.g., knowledge, attitudes) will impact on HPV test acceptability by women is crucial for ensuring adequate public health practices to optimize cervical screening uptake. We used mixed methods research synthesis to provide a categorization of the relevant factors related to HPV primary screening for cervical cancer and describe their influence on women's acceptability of HPV testing. We searched Medline, Embase, PsycINFO, CINAHL, Global Health and Web of Science for journal articles between January 1, 1980 and October 31, 2017 and retained 22 empirical articles. Our results show that while most factors associated with HPV test acceptability are included in the Health Belief Model and/or Theory of Planned Behavior (e.g., attitudes, knowledge), other important factors are not encompassed by these theoretical frameworks (e.g., health behaviors, negative emotional reactions related to HPV testing). The direction of influence of psychosocial factors on HPV test acceptability was synthesized based on 14 quantitative studies as: facilitators (e.g., high perceived HPV test benefits), barriers (e.g., negative attitudes towards increased screening intervals), contradictory evidence (e.g., sexual history) and no impact (e.g., high perceived severity of HPV infection). Further population-based studies are needed to confirm the impact of these factors on HPV-based screening acceptability.
Topics: Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Human Papillomavirus DNA Tests; Humans; Papillomaviridae; Papillomavirus Infections; Patient Acceptance of Health Care; Uterine Cervical Neoplasms
PubMed: 30172799
DOI: 10.1016/j.ypmed.2018.08.034 -
Health Care For Women International 2024We performed a systematic review and meta-analysis to evaluate the accuracy of screening cervical cancer tests as alternative standalone methods. The combined estimates... (Meta-Analysis)
Meta-Analysis
We performed a systematic review and meta-analysis to evaluate the accuracy of screening cervical cancer tests as alternative standalone methods. The combined estimates of sensitivity of visual inspection with acetic acid, visual inspection with lugol's iodine, conventional pap smear, liquid-based cytology, High risk HPV testing by clinician, High risk HPV testing by self- sampling, cervicography were 64%, 80%, 55%, 70%, 70% and 67% respectively; the combine values of specificity of these screening strategies were 88%, 88%, 96%, 59%, 94%, and 95% respectively. Our findings draw attention to an attractive opinion to facilitate the collection of specimens for DNA HPV by patients in settings where they don't have access to a regular screening programs.
Topics: Female; Humans; Uterine Cervical Neoplasms; Uterine Cervical Dysplasia; Vaginal Smears; Early Detection of Cancer; Papillomavirus Infections; Mass Screening; Sensitivity and Specificity
PubMed: 35084291
DOI: 10.1080/07399332.2021.1998059