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The Medical Clinics of North America Mar 2023Cervical cancer screening is an essential component of preventative health care. Although rates of cervical cancer have decreased over the last 50 years, survival has... (Review)
Review
Cervical cancer screening is an essential component of preventative health care. Although rates of cervical cancer have decreased over the last 50 years, survival has not changed dramatically, and there are significant discrepancies in disease detection by race. Multiple national organizations contribute to the recommendations for cervical cancer screening timing, testing modalities, and management. This article aims to summarize the current understanding of cervical cancer pathogenesis, options for cervical cancer screening, and the shift in guidelines toward risk-based clinical management.
Topics: Female; Humans; Uterine Cervical Neoplasms; Early Detection of Cancer; Papillomavirus Infections; Delivery of Health Care; Mass Screening; Papanicolaou Test; Papillomaviridae
PubMed: 36759096
DOI: 10.1016/j.mcna.2022.10.006 -
European Review For Medical and... Oct 2021Cervical cancer is largely preventable. Although routine Pap smear screening has reduced cervical cancer-related mortality by 70-80% in all countries and by... (Review)
Review
OBJECTIVE
Cervical cancer is largely preventable. Although routine Pap smear screening has reduced cervical cancer-related mortality by 70-80% in all countries and by approximately 90% in developing countries, the gynecologist is still confronted with women in advanced stages of the disease. The eradication of cervical cancer depends on identifying the disease early and removing barriers to its timely detection. Given the significant burden of cervical cancer in Asian countries, we investigated factors related to its screening in Asia.
MATERIALS AND METHODS
A comprehensive search was carried out in databases such as Medline, Web of Science and Scopus for articles published until September 2020. The following keywords were used: vaginal smear, Pap smear, cervical cancer screening, barriers, obstacles, challenge, early detection, the name of each Asian country, and a combination of these words.
RESULTS
Seventy-five articles were included in the study. The investigation revealed various factors related to cervical cancer screening in Asian women, including sociodemographic factors, awareness, attitudes and beliefs, perceived risk, psychological factors, self-efficacy, previous experiences, time, household, culture, fatalism, social support, access, cost, safety, insurance and health system-related factors.
CONCLUSIONS
Several barriers hinder the efficacy of a screening program. Its success requires the use of educational interventions, professional and inter-professional cooperation, allocation of sufficient resources, and policymakers focusing on the elimination of barriers.
Topics: Asian People; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 34661271
DOI: 10.26355/eurrev_202110_26889 -
Best Practice & Research. Clinical... Feb 2018Cervical cancer affects women in their reproductive ages. Screening is an important secondary prevention strategy. The long process of carcinogenic transformation from... (Review)
Review
Cervical cancer affects women in their reproductive ages. Screening is an important secondary prevention strategy. The long process of carcinogenic transformation from human papillomavirus (HPV) infection to invasive cancer provides ample opportunities to detect the disease at a stage when treatment is highly effective. Suitable screening tests are cytology, visual inspection after acetic acid application and HPV detection tests. Evidence of effectiveness of the tests to reduce cervical cancer mortality and the cost-effectiveness of screening programs have been demonstrated. Cervical intraepithelial neoplasia grade 2 and grade 3 are the high-grade cervical cancer precursors and need to be treated. Treatment is safe and effective with ablative or excisional techniques. The World Health Organization recommends screening women at least once in a lifetime between 30 and 49 years of age and ensuring effective treatment of the detected abnormalities. Combination of HPV vaccination and population-based screening will be instrumental in eliminating cervical cancer.
Topics: Disease Progression; Early Detection of Cancer; Female; Global Burden of Disease; Humans; Mass Screening; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Secondary Prevention; Uterine Cervical Neoplasms; Vaginal Smears; Uterine Cervical Dysplasia
PubMed: 28988647
DOI: 10.1016/j.bpobgyn.2017.08.012 -
JAAPA : Official Journal of the... Mar 2022For women ages 21 to 65 years who have not had a hysterectomy, the US Preventive Services Task Force (USPSTF) recommends cervical cancer screening with cytology (Pap... (Review)
Review
For women ages 21 to 65 years who have not had a hysterectomy, the US Preventive Services Task Force (USPSTF) recommends cervical cancer screening with cytology (Pap smear) every 3 years or a combination of cytology and human papillomavirus (HPV) testing every 5 years. However, foreign-born women were less likely to have received a Pap smear compared with US-born women. This article reviews barriers to cervical cancer screening for foreign-born women.
Topics: Adult; Aged; Early Detection of Cancer; Emigrants and Immigrants; Female; Humans; Mass Screening; Middle Aged; Papanicolaou Test; Papillomavirus Infections; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult
PubMed: 35120364
DOI: 10.1097/01.JAA.0000819564.35151.0a -
PloS One 2021The knowledge of Pap smear and uptake of preventive behaviors to prevent cervical cancer are the most important contributors to the advanced stage of the disease....
BACKGROUND
The knowledge of Pap smear and uptake of preventive behaviors to prevent cervical cancer are the most important contributors to the advanced stage of the disease. Knowledge is one of the most leading factors to predict the health behaviors and a helpful factor in performing screening procedures. This study aimed to investigate Saudi Arabian women knowledge of Pap testing in relation to their intention to undergo the test.
METHODS
An online survey including demographic characteristics (3 questions), knowledge (13 questions), and intentions (3 questions) towards Pap smear was completed by 467 Saudi Arabian women. Data were analyzed through SPSS version 22, using descriptive statistics and correlation to measure the relationship between knowledge, demographic factors, and intention.
RESULTS
The study found that average level of knowledge was 1.3 which is between high and moderate knowledge, and the average score for the intention was 2.88, to indicate that the intentions to uptake Pap smear among the participants were above the average. The study revealed a significant correlation between demographic factors and intention (p<0.01).
CONCLUSION
Findings from the current study can inform health care providers about Saudi Arabian women knowledge of Pap smear and the intention to uptake the test. Strategies to motivate women to undergo Pap screening should be introduced.
Topics: Adolescent; Adult; Aged; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Middle Aged; Papanicolaou Test; Patient Acceptance of Health Care; Saudi Arabia; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult
PubMed: 34166452
DOI: 10.1371/journal.pone.0253850 -
The Gulf Journal of Oncology Jan 2022The study aim is to determine the association of post-menopausal status with abnormal Pap smear cytology and cervical dysplasia detected by colposcopically-directed...
INTRODUCTION
The study aim is to determine the association of post-menopausal status with abnormal Pap smear cytology and cervical dysplasia detected by colposcopically-directed biopsy. We also study the association of biopsy-confirmed dysplasia with Pap smear results.
PATIENTS AND METHODS
This retrospective study included 480 women with abnormal Pap smear results who were referred for colposcopy. Covariates considered included demographic (age, race/ethnicity, smoking status), sexual activity (age first sexual intercourse, number lifetime partners, duration current partner), and disease (HIV, high-risk HPV, immunosuppression).
RESULTS
Post-menopausal status was not significantly associated with abnormal Pap smear cytology or cervical dysplasia. We found a statistically significant association of high-grade dysplasia with high-grade Pap smear results: ASC-H (B=3.43, SE=0.84, p< 0.001); HSIL (B=3.50, SE=0.84, p< 0.001) and AGC (B=3.47, SE=1.02, p< 0.01).
DISCUSSION AND CONCLUSION
Although clinicians may want to consider not requiring colposcopically-directed biopsy for certain post-menopausal patients, we recommend continuing with current cervical cancer guidelines of screening for all women regardless of menopausal status.
Topics: Female; Humans; Papanicolaou Test; Postmenopause; Retrospective Studies; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35156642
DOI: No ID Found -
Journal of Immigrant and Minority Health Feb 2022Although multiple studies have shown that resettled refugee women are less likely to receive preventative cancer screenings like pap smears and mammograms, a small...
Although multiple studies have shown that resettled refugee women are less likely to receive preventative cancer screenings like pap smears and mammograms, a small number have demonstrated the opposite. This retrospective chart review, conducted between January 2017 and October 2018, compares pap smear and mammogram rates of patients seen in a refugee-specific OB/GYN clinic with patients from the general OB/GYN clinic at the same institution. Data from 298 patients (149 refugee and 149 general clinic patients matched by age and date-of-visit) were analyzed. Pap smear screening rates were 90.60% in the refugee group and 73.83% in the general group [p < 0.009, aOR 3.46 (1.36-8.81)], while mammogram screening rates were 36.84% and 38.60%, respectively (p = 0.46). The provision of holistic services meeting refugee women's unique needs can effectively increase pap smear screening rates.
Topics: Female; Humans; Mass Screening; Papanicolaou Test; Refugees; Retrospective Studies; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 34714467
DOI: 10.1007/s10903-021-01297-2 -
Diagnostic Cytopathology Apr 2021Cervical cancer progresses slowly, increasing the chance of early detection of pre-neoplastic lesions via Pap exam test and subsequently preventing deaths. However, the... (Review)
Review
BACKGROUND
Cervical cancer progresses slowly, increasing the chance of early detection of pre-neoplastic lesions via Pap exam test and subsequently preventing deaths. However, the exam presents both false-negatives and false-positives results. Therefore, automatic methods (AMs) of reading the Pap test have been used to improve the quality control of the exam. We performed a literature review to evaluate the feasibility of implementing AMs in laboratories.
METHODS
This work reviewed scientific publications regarding automated cytology from the last 15 years. The terms used were "Papanicolaou test" and "Automated cytology screening" in Portuguese, English, and Spanish, in the three scientific databases (SCIELO, PUBMED, MEDLINE).
RESULTS
Of the resulting 787 articles, 34 were selected for a complete review, including three AMs: ThinPrep Imaging System, FocalPoint GS Imaging System and CytoProcessor. In total, 1 317 148 cytopathological slides were evaluated automatically, with 1 308 028 (99.3%) liquid-based cytology slides and 9120 (0.7%) conventional cytology smears. The AM diagnostic performances were statistically equal to or better than those of the manual method. AM use increased the detection of cellular abnormalities and reduced false-negatives. The average sample rejection rate was ≤3.5%.
CONCLUSION
AMs are relevant in quality control during the analytical phase of cervical cancer screening. This technology eliminates slide-handling steps and reduces the sample space, allowing professionals to focus on diagnostic interpretation while maintaining high-level care, which can reduce false-negatives. Further studies with conventional cytology are needed. The use of AM is still not so widespread in cytopathology laboratories.
Topics: Automation, Laboratory; Female; Humans; Papanicolaou Test; Uterine Cervical Neoplasms
PubMed: 33548162
DOI: 10.1002/dc.24708 -
Journal of Women's Health (2002) Aug 2022Pap smear has a central role in cervical cancer screening. Previous studies have found that female patients with disabilities are less likely to receive a Pap smear as...
Pap smear has a central role in cervical cancer screening. Previous studies have found that female patients with disabilities are less likely to receive a Pap smear as recommended by guidelines. The aim of our study was to examine the association between physical disability and Pap smear receipt in Israel. This cross-sectional study was conducted using the electronic medical records of the second largest health care maintenance organization in Israel. All female patients during 2012-2017 aged 25-65 were identified. The exposure variable was physical disability, and the outcome variable was Pap smear receipt. We used logistic regression to control for covariates. A total of 391,259 patients were eligible for this study, 6,720 (1.7%) with physical disability. 56.7% of patients with disabilities had received Pap smear compared to 63.3% of patients without disabilities, odds ratio (OR) 0.76, 95% confidence interval [CI] 0.72-0.80. When adjusting to sociodemographic and clinical covariates, patients with disabilities were less likely to receive Pap smear, adjusted OR 0.83, 95% CI 0.79-0.88. For all patients, older age, lower socioeconomic status, religious minorities, cardiovascular disease, type-2 diabetes mellitus, hypertension, smoking, and obesity were associated with lower odds of receipt of Pap smear. A history of nongynecologic oncologic disease was associated with increased odds of Pap smear receipt. Our study highlights the disparities between patients with and without physical disability with regard to screening for cervical cancer by receipt of Pap smear. Creating an appropriate practice with adequate access to patients with disability should be a focus for health care providers and policy makers.
Topics: Cross-Sectional Studies; Disabled Persons; Early Detection of Cancer; Female; Humans; Mass Screening; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35072543
DOI: 10.1089/jwh.2021.0447 -
Revue D'epidemiologie Et de Sante... Feb 2018Cervical cancer is a very common malignancy amongst women worldwide. Pap smear is an effective and inexpensive screening test in asymptomatic women. The aim of this...
BACKGROUND
Cervical cancer is a very common malignancy amongst women worldwide. Pap smear is an effective and inexpensive screening test in asymptomatic women. The aim of this paper was to assess the prevalence of Pap smear screening for cervical cancer among Lebanese women and to determine associated sociodemographic and psychosocial characteristics.
METHODS
This national survey included 2255 women, selected by multi-stage random cluster sampling across Lebanon. A questionnaire about practices and perceptions related to cervical cancer screening was developed based on the "Health Belief Model".
RESULTS
The weighted national prevalence of "ever-use" of the Pap smear for screening purposes was 35%. Most important determinants of screening behavior were: residence within Greater Beirut, higher socio-economic status and educational attainment, marriage status, presence of a health coverage, awareness of Pap smear usefulness, knowing someone who had already done it, and a balance between perceived benefits and perceived barriers to Pap smear screening.
CONCLUSION
Regular information campaigns regarding the availability and effectiveness of the test should be devised, targeting in priority the sexually vulnerable women in Lebanon. Moreover, healthcare providers should be encouraged to discuss with their patients the opportunity of obtaining a Pap smear.
Topics: Adolescent; Adult; Aged; Culture; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Lebanon; Mass Screening; Middle Aged; Papanicolaou Test; Surveys and Questionnaires; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult
PubMed: 29249573
DOI: 10.1016/j.respe.2017.10.004