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Asian Pacific Journal of Cancer... Oct 2022Although various improvements have been made in the reporting of the Papanicolaou (PAP) test in recent years, there remain several challenges that have yet to be...
BACKGROUND
Although various improvements have been made in the reporting of the Papanicolaou (PAP) test in recent years, there remain several challenges that have yet to be addressed in terms of determining a standardized methodology for categorizing atypical squamous cells of undetermined significance (ASC US).
METHODS
The present study focuses on evaluating the performance of the methylation status of two genes (CGB3 and NOP56) using a total of 200 PAP samples, which were divided into the "determined" group, with 78 samples based on cytology, and the "undetermined" group (ASC US), with 122 samples. The promoter methylation status of the CGB3 and NOP56 genes was detected for the 200 PAP samples using methylation specific PCR (MSP). The diagnostic abilities of the CGB3 and NOP56 genes in PAP samples were measured, and receiver operating characteristic (ROC) curves were generated using Python programming language.
RESULTS
Based on the validation of CGB3 and NOP56 methylation in the 200 PAP samples, both genes exhibited higher methylation percentages in abnormal samples compared with normal samples. In addition, on the basis of diagnostic performance analysis, the CGB3 gene exhibited the highest sensitivity and specificity in both histology based ASC US and cytology based 'determined' PAP samples, with significant diagnostic abilities [area under the curve (AUC) values of 0.83 and 0.74, respectively, where AUC ≥0.5 was determined to be significant] to distinguish between the "normal" and "abnormal" samples.
CONCLUSION
The findings of the present study will contribute toward identifying a DNA methylation marker for the early detection of abnormal samples before they reach the initial stages of cervical cancer, and should prove to be helpful for clinicians in terms of diagnosing patients whose cells are ASC US.
.Topics: Female; Humans; Papanicolaou Test; Atypical Squamous Cells of the Cervix; Vaginal Smears; Uterine Cervical Neoplasms; DNA Methylation; Papillomavirus Infections; Uterine Cervical Dysplasia
PubMed: 36308381
DOI: 10.31557/APJCP.2022.23.10.3541 -
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 -
Revista Gaucha de Enfermagem Mar 2016Objectives To identify socioeconomic and regional inequalities of pap smear coverage in the state of Rio Grande do Sul. Methods An ecological study based on data of the...
Objectives To identify socioeconomic and regional inequalities of pap smear coverage in the state of Rio Grande do Sul. Methods An ecological study based on data of the 2011-2012 national health information system to estimate the annual coverage of pap smears for the overall female population of the state and for women without private health insurance. We estimated annual pap smear coverage according to the Municipal Social Vulnerability Index and health macro-regions and regions of the state. Results The percentage of women without private health insurance ranged from 38.1% to 94.2% in the health regions. Pap smear coverage was 17.3% for the overall female population and 23.8% for women without private health insurance. Pap smear coverage was higher in more socially vulnerable municipalities and regions with a higher percentage of women with private health insurance. Conclusions The prevalence of private health insurance should be considered in studies that address the coverage of the Brazilian Unified Health System (SUS).
Topics: Adult; Brazil; Early Detection of Cancer; Female; Healthcare Disparities; Humans; Insurance Coverage; Insurance, Health; Middle Aged; Papanicolaou Test; Poverty Areas; Rural Population; Social Determinants of Health; Urban Population; Uterine Cervical Neoplasms; Vulnerable Populations
PubMed: 26982680
DOI: 10.1590/1983-1447.2016.01.52287 -
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 -
European Journal of Public Health Dec 2017In 2012 the National Screening Program for all women between 25 and 64 years of age was launched in Romania. Public awareness is an important factor in the success of a...
BACKGROUND
In 2012 the National Screening Program for all women between 25 and 64 years of age was launched in Romania. Public awareness is an important factor in the success of a screening program. For this reason, we intended to assess the perception and the level of awareness of Romanian women regarding the Pap test in the prevention of cervical cancer.
METHODS
A cross-sectional study was conducted among 454 women from rural and urban areas. For our study, we used a questionnaire covering general characteristics, awareness, knowledge and practices regarding cervical cancer and Pap smear.
RESULTS
431 participants (95%) had heard of cervical cancer and Pap smear but only 71.8% knew the exact role of it. Bivariate analysis showed that knowledge about the importance of the Pap smear, early detection and treatment of early-stage cervical cancer was reduced among women with low socio-economic status, mainly living in rural area. The most frequent reasons for avoiding Pap smear screening were: lack of money, embarrassment or fear of gynaecological consultation and pain, the feeling that they don't need it, misconceptions about cervical cancer, fatalistic attitude, perceived low susceptibility to cervical cancer.
CONCLUSIONS
Because the uptake and the success of cervical cancer screening are determined by women's knowledge and awareness of Pap smear, it is critical to improve these perceptions in the near future especially in rural area characterized by a low socio-economic status.
Topics: Adult; Cross-Sectional Studies; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Middle Aged; Papanicolaou Test; Romania; Rural Population; Surveys and Questionnaires; Urban Population; Uterine Cervical Neoplasms
PubMed: 29020396
DOI: 10.1093/eurpub/ckx112 -
Acta Cytologica 2017Cytodiagnoses of specific malignancies are enabled through analyses of abnormal nuclear chromatin and cytoplasmic features in stained cells. (Review)
Review
OBJECTIVE
Cytodiagnoses of specific malignancies are enabled through analyses of abnormal nuclear chromatin and cytoplasmic features in stained cells.
AIM
The objective of this work was to explore the inception, development, and chemistry of the Pap stain method introduced in 1942 by Dr. G.N. Papanicolaou.
STUDY DESIGN
To achieve this, we carried out a review of the English literature.
RESULTS
Between 1914 and 1933, Papanicolaou first analyzed vaginal squamous cells in guinea pigs and later in human vaginal fluid samples using hematoxylin and eosin with limited color reactions, correlating the cell-type morphology with endocrinology and histology. The 5-dye Pap stain method evolved through 2 salient phases. The first, between 1933 and 1942, saw the introduction of alcohol-ether fixation and aqueous waterblue staining to enhance cellular transparency, aiding the distinction of cervical cancer cells from benign cells, with quantitative and qualitative assessment of squamous cell maturity. The second phase, between 1942 and 1960, saw the introduction and refinement of various alcoholic cytoplasmic counterstaining schemes with orange G and EA (light green, Bismarck brown, eosin) and phosphotungstic acid, allowing wider ranges of polychromasia and further enhancing cellular visualization, facilitating the distinction of cell types and improving diagnostic confidence.
CONCLUSIONS
Development of the Pap stain method followed specific historical and scientific events. The staining method evolved following incremental improvements in cellular transparency achieved through tailored cellular fixation and cytoplasmic staining using variable dye and pH combinations.
Topics: Animals; Coloring Agents; Cytoplasm; Female; Humans; Papanicolaou Test; Staining and Labeling; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 28384641
DOI: 10.1159/000457827 -
BMJ Open Oct 2022There is a concern about performance of the screening approaches, where information on the quality of novel and affordable screening approaches that will perform well in...
Performance of HPV testing, Pap smear and VIA in women attending cervical cancer screening in Kilimanjaro region, Northern Tanzania: a cross-sectional study nested in a cohort.
OBJECTIVE
There is a concern about performance of the screening approaches, where information on the quality of novel and affordable screening approaches that will perform well in remote areas is warranted. This lack of information makes it difficult to prioritise resource use in efforts to improve cervical cancer outcomes. We aimed to compare the diagnostic value of human papillomavirus (HPV) testing on self-collected samples, Pap smear and visual inspection of the cervix with acetic acid (VIA) tests for detection of high-grade cervical intraepithelial neoplasia or worse (CIN2+).
DESIGN
A combined cross-sectional and cohort study.
SETTING
Three primary healthcare centres in Kilimanjaro region, Tanzania.
PARTICIPANTS
1620 women undergoing cervical cancer screening from December 2018 to September 2021. Inclusion criteria were being aged 25-60 years, and no history of premalignant or cervical cancer. Exclusion criteria were overt signs of cancer and previous hysterectomy.
INTERVENTIONS
Participants underwent HPV self-sampling with Evalyn Brush and Care HPV kit assay was used to determine prevalence of high-risk HPV infection. Women with positive HPV test were together with a random sample of HPV negative women scheduled for follow-up where VIA was performed, and Pap smear and cervical biopsies obtained.
RESULTS
Of 1620 women enrolled, 229 (14.1%) were HPV positive and 222 of these attended follow-up together with 290 (20.8%) women with negative HPV test. On VIA, 17.6% were positive. On Pap smear, 8.0% were classified as high-grade squamous intraepithelial lesion. The sensitivity and specificity, respectively, of the various tests, compared with histopathology for the detection of CIN2+ were: HPV test 62.5%, 59.3%; Pap smear 82.8%, 82.1% and; VIA 48.4%, 56.8%. When combined, the sensitivity and specificity for HPV and Pap smear were 90.6%, 70.6% while HPV and VIA were 65.6% and 75.5% for the detection of CIN2+.
CONCLUSIONS
The performance of care HPV testing on self-collected samples opens the possibility of increasing coverage and early detection in resource-constrained settings.
Topics: Female; Humans; Male; Papanicolaou Test; Uterine Cervical Neoplasms; Papillomaviridae; Cross-Sectional Studies; Alphapapillomavirus; Early Detection of Cancer; Papillomavirus Infections; Cohort Studies; Tanzania; Vaginal Smears; Mass Screening
PubMed: 36316070
DOI: 10.1136/bmjopen-2022-064321 -
Journal of Nursing Scholarship : An... Sep 2016The aim of this study was to review published studies to identify and describe barriers to Papanicolaou (Pap) smear screening among women in sub-Saharan Africa. (Review)
Review
PURPOSE
The aim of this study was to review published studies to identify and describe barriers to Papanicolaou (Pap) smear screening among women in sub-Saharan Africa.
DESIGN AND METHODS
Guided by Cooper's integrative review methodology, studies published between 2006 and 2015 were identified by searching electronic databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, MEDLINE, ProQuest, and PsycINFO using specified search terms. Using this strategy, 224 articles were identified and screened for duplication and by reading titles, abstracts, and full texts. Seventeen articles met the inclusion criteria and were appraised using relevant tools for qualitative and quantitative designs. No relevant articles published in 2006, 2007, and 2014 were found.
FINDINGS
All 17 articles had good methodological quality and were included in the review. The studies were from 10 sub-Saharan countries and from different settings. Content analysis of the data revealed three major themes coded as client, provider, and system barriers. The most common client barriers were lack of knowledge and awareness about Pap smear screening, fear of cancer, belief of not being at risk for cervical cancer, and that a Pap smear is not important unless one is ill and cultural or religious factors. Provider barriers were failure to inform or encourage women to screen. Major system barriers were unavailability and inaccessibility of the Pap test.
CONCLUSIONS
The review provided evidence of barriers to Pap smear screening among sub-Saharan women. Although there were some variations from country to country, sub-Saharan countries share similar constraints to Pap smear screening. These findings have important implications for practice and policy.
CLINICAL RELEVANCE
Understanding the client, provider, and system barriers to cervical cancer screening could guide development of effective interventions.
Topics: Africa South of the Sahara; Early Detection of Cancer; Female; Health Services Accessibility; Humans; Papanicolaou Test; Uterine Cervical Neoplasms
PubMed: 27434871
DOI: 10.1111/jnu.12232 -
Annual International Conference of the... Jul 2019This study aims to apply Mask Regional Convolutional Neural Network (Mask R-CNN) to cervical cancer screening using pap smear histological slides. Based on our current... (Review)
Review
This study aims to apply Mask Regional Convolutional Neural Network (Mask R-CNN) to cervical cancer screening using pap smear histological slides. Based on our current literature review, this is the first attempt of using Mask R-CNN to detect and analyze the nucleus of the cervical cell, screening for normal and abnormal nuclear features. The data set were liquid-based histological slides obtained from Thammasat University (TU) Hospital. The slides contained both cervical cells and various artifacts such as white blood cells, mimicking the slides obtained in actual clinical settings. The proposed algorithm achieved mean average precision (mAP) of 57.8%, accuracy of 91.7%, sensitivity of 91.7%, and specificity of 91.7% per image. As we needed to evaluate the efficiency of our algorithm in comparison to single cell classification algorithm (Zhang et al., IEEE JBHI, vol. 21, no. 6, pp. 1633, 2017), we modified our method to also classify single cells on TU dataset test using Mask R-CNN segmentation. The results obtained had an accuracy of 89.8%, sensitivity of 72.5%, and specificity of 94.3%.
Topics: Deep Learning; Early Detection of Cancer; Female; Humans; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 31947460
DOI: 10.1109/EMBC.2019.8856369 -
The Yale Journal of Biology and Medicine Jun 2016Women comprise nearly one-quarter of all people living with human immunodeficiency virus (HIV) in the U.S. and 20 percent of incident annual cases. Though women overall... (Review)
Review
Women comprise nearly one-quarter of all people living with human immunodeficiency virus (HIV) in the U.S. and 20 percent of incident annual cases. Though women overall are more likely than men to be diagnosed with HIV and engage in care, they are as unlikely to successfully achieve viral suppression with antiretroviral therapy, suggesting gender-based disparities that should be addressed by gender-responsive policies and programs. Using the socioecological model of health and syndemics theory, we comprehensively reviewed published literature to evaluate reasons for and ways to address gender differences in HIV risk and treatment. We discuss the biologic, sociocultural, interpersonal, and behavioral contexts of HIV risk that affect women, comprehensive healthcare for women with HIV that includes pregnancy planning or prevention, and policy implications.
Topics: Female; HIV Infections; Humans; Papanicolaou Test; Women's Health
PubMed: 27354845
DOI: No ID Found