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Women & Health Jul 2023Cervical cancer is a significant disease affecting women's health in terms of its incidence and is one of the most preventable cancers. However, participation in early...
Cervical cancer is a significant disease affecting women's health in terms of its incidence and is one of the most preventable cancers. However, participation in early cervical cancer-screening programs has been unsatisfactory for various reasons. In this descriptive, relationship-seeking study, we examined the relationship between fatalism tendency, an individual barrier to participation in early cancer screening programs, and women's attitudes toward the early diagnosis of cervical cancer and undergoing the Pap smear test. Research data were collected between August 1, 2019 and December 1, 2019, in a city in northern Turkey from 602 women using a participant information form, the Attitudes Toward Early Diagnosis in Cervical Cancer Scale, and the Fatalism Tendency Scale. We found that fatalistic tendencies in women were a predictor of their attitudes toward the early diagnosis of cervical cancer (odds ratio [OR] = -0.64, β = .47, < .001) and undergoing the Pap smear test (OR = 1.01, β = -.15, < .001). Women with high fatalism tendencies had a more negative attitude toward the early diagnosis of cervical cancer and their participation rate in Pap smear screening programs was low. Therefore, nurses must consider women's fatalistic tendencies and attitudes toward cancer when organizing educational and informational programs that encourage participation in cervical cancer screening.
Topics: Female; Humans; Vaginal Smears; Uterine Cervical Neoplasms; Early Detection of Cancer; Health Knowledge, Attitudes, Practice; Papanicolaou Test; Mass Screening
PubMed: 37303197
DOI: 10.1080/03630242.2023.2223698 -
Revista Brasileira de Ginecologia E... Feb 2022To determine the accuracy of colposcopy findings in diagnosing cervical intraepithelial neoplasia (CIN) in women with an atypical squamous cells, cannot exclude...
OBJECTIVE
To determine the accuracy of colposcopy findings in diagnosing cervical intraepithelial neoplasia (CIN) in women with an atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) pap smear result and analyze whether the prevalence of HSIL and cancer correlates with sociodemographic risk factors and specific colposcopic findings.
METHODS
Colposcopic findings and sociodemographic risk factors were analyzed as possible predictors of a CIN 2 or worse diagnosis in women with an ASC-H pap smear result.
RESULTS
Accuracy of the colposcopic impression was 92%, sensitivity was 91.6%, and specificity was 93.1%, with a positive predictive value of 96.4% and negative predictive value of 84.3%. Diagnosis of CIN 2 or worse was more frequent in patients with a previous history of cervical dysplasia and pre-menopausal patients. Identification of major colposcopic findings, dense acetowhite epithelium, coarse mosaicism, and punctuation correlated significantly with CIN 2 or worse.
CONCLUSION
Colposcopy performed by an experienced examiner can accurately differentiate patients with CIN 1 or less from patients with CIN 2 or worse. Diagnosis of CIN 2 or worse was more frequent in patients with a previous history of cervical dysplasia and pre-menopausal patients. The degree of acetowhite changes was the best colposcopic feature to predict CIN2 or worse.
Topics: Colposcopy; Female; Humans; Papanicolaou Test; Pregnancy; Uterine Cervical Neoplasms; Vaginal Smears; Uterine Cervical Dysplasia
PubMed: 35213916
DOI: 10.1055/s-0042-1742289 -
Acta Cytologica 2020YouTube is one of the most popular video-sharing platforms and is used by many people as a source of information regarding health conditions. Although there are many...
AIM
YouTube is one of the most popular video-sharing platforms and is used by many people as a source of information regarding health conditions. Although there are many studies examining YouTube health-related videos in terms of quality, content and accuracy, there is not any study observing the content of YouTube videos about the "Pap smear test." Therefore, we intended to evaluate YouTube videos related to the Pap smear test.
METHODS
We made a search by typing "Pap smear test" and observed the first 100 videos. According to our selection criteria, only 42 videos were reviewed. We used 3 different questionnaires to rate the videos. The videos were independently rated by 2 gynecologists in terms of technical aspects, follow-up protocol, and video quality.
RESULTS
Our study showed that clarity of the technical aspects of Pap smear testing (Q1) was 40% and that of the follow-up protocol (Q2) was only 11%. In terms of video quality (Q3), the adequacy rate was 34%. There was a statistically significant negative correlation between search rank and the video power index (which increased as the ranking decreased to rank 1, r: -0.481).
CONCLUSION
We did not find quality and reliable information on YouTube videos about the Pap smear test, which is important for early detection of cervical cancers. While preparing health-related videos for YouTube and similar websites, the support of professional healthcare workers will help provide more accurate content.
Topics: Consumer Health Information; Female; Humans; Papanicolaou Test; Patient Education as Topic; Social Media; Surveys and Questionnaires; Vaginal Smears; Video Recording
PubMed: 32396906
DOI: 10.1159/000507105 -
Biomedical Engineering Online Feb 2019Cervical cancer is preventable if effective screening measures are in place. Pap-smear is the commonest technique used for early screening and diagnosis of cervical...
BACKGROUND
Cervical cancer is preventable if effective screening measures are in place. Pap-smear is the commonest technique used for early screening and diagnosis of cervical cancer. However, the manual analysis of the pap-smears is error prone due to human mistake, moreover, the process is tedious and time-consuming. Hence, it is beneficial to develop a computer-assisted diagnosis tool to make the pap-smear test more accurate and reliable. This paper describes the development of a tool for automated diagnosis and classification of cervical cancer from pap-smear images.
METHOD
Scene segmentation was achieved through a Trainable Weka Segmentation classifier and a sequential elimination approach was used for debris rejection. Feature selection was achieved using simulated annealing integrated with a wrapper filter, while classification was achieved using a fuzzy C-means algorithm.
RESULTS
The evaluation of the classifier was carried out on three different datasets (single cell images, multiple cell images and pap-smear slide images from a pathology lab). Overall classification accuracy, sensitivity and specificity of '98.88%, 99.28% and 97.47%', '97.64%, 98.08% and 97.16%' and '95.00%, 100% and 90.00%' were obtained for each dataset, respectively. The higher accuracy and sensitivity of the classifier was attributed to the robustness of the feature selection method that accurately selected cell features that improved the classification performance and the number of clusters used during defuzzification and classification. Results show that the method outperforms many of the existing algorithms in sensitivity (99.28%), specificity (97.47%), and accuracy (98.88%) when applied to the Herlev benchmark pap-smear dataset. False negative rate, false positive rate and classification error of 0.00%, 10.00% and 5.00%, respectively were obtained when applied to pap-smear slides from a pathology lab.
CONCLUSIONS
The major contribution of this tool in a cervical cancer screening workflow is that it reduces on the time required by the cytotechnician to screen very many pap-smears by eliminating the obvious normal ones, hence more time can be put on the suspicious slides. The proposed system has the capability of analyzing a full pap-smear slide within 3 min as opposed to the 5-10 min per slide in the manual analysis. The tool presented in this paper is applicable to many pap-smear analysis systems but is particularly pertinent to low-cost systems that should be of significant benefit to developing economies.
Topics: Early Detection of Cancer; Female; Fuzzy Logic; Humans; Image Processing, Computer-Assisted; Papanicolaou Test; Sensitivity and Specificity; Uterine Cervical Neoplasms
PubMed: 30755214
DOI: 10.1186/s12938-019-0634-5 -
Medicine Oct 2015The aim of this study was to analyze the correlation between the first diagnosis of high-grade Vaginal Intraepithelial Neoplasia (HG-VaIN: VaIN 2-VaIN 3) and the...
The aim of this study was to analyze the correlation between the first diagnosis of high-grade Vaginal Intraepithelial Neoplasia (HG-VaIN: VaIN 2-VaIN 3) and the cytological abnormalities on the referral pap smear.All the women with histological diagnosis of HG-VaIN consecutively referred to the Gynecological Oncology Unit of the Aviano National Cancer Institute (Aviano, Italy) from January 1991 to April 2014 and with a pap smear performed in the 3 months before the diagnosis were considered, and an observational cohort study was performed.A total of 87 women with diagnosis of HG-VaIN were identified. Major cytological abnormalities (HSIL and ASC-H) on the referral pap smear were significantly more frequent than lesser abnormalities (ASC-US and LSIL) in postmenopausal women (64.9% vs 36.7%, P = 0.02) and in women with a previous diagnosis of HPV-related cervical preinvasive or invasive lesions (70.5% vs 39.5%, P = 0.01). Diagnosis of VaIN 3 was preceded by major cytological abnormalities in most of the cases (72.7% vs 27.3%, P < 0.001).The diagnosis of HG-VaIN can be preceded by different abnormalities on referral pap smear. Major abnormalities are usually reported in postmenopausal women and in women with previous cervical HPV-related disease. However, ASC-US or LSIL do not exclude HG-VaIN, especially VaIN2. An accurate examination of the whole vaginal walls (or vaginal vault) must be performed in all the women who underwent colposcopy for an abnormal pap smear, and a biopsy of all suspicious areas is mandatory.
Topics: Adolescent; Adult; Aged; Carcinoma in Situ; Cohort Studies; Female; Humans; Middle Aged; Neoplasm Grading; Papanicolaou Test; Retrospective Studies; Vaginal Neoplasms; Vaginal Smears; Young Adult
PubMed: 26496321
DOI: 10.1097/MD.0000000000001827 -
Current Opinion in Obstetrics &... Apr 2023To review the recommendations for cervical cancer screening in older women and to determine the evidence upon which the current and emerging recommendations are based... (Review)
Review
PURPOSE OF REVIEW
To review the recommendations for cervical cancer screening in older women and to determine the evidence upon which the current and emerging recommendations are based on. To evaluate the possible consequences of stopping cervical cancer screening in older women.
RECENT FINDINGS
Recommendations are to space cervical cancer screening intervals for women aged 21-65 and stop in women older than 65. Cervical cancer incidence and mortality burden are significant in women over the age of 65. Human papillomavirus (HPV) vaccination rates are poor in older women. Advanced cervical cancer rates are increasing, including adenocarcinoma rates. Vulvar carcinoma rates are also increasing, and gynecological care and exams are less frequent when women are not getting routine pap testing.
SUMMARY
The current review shows that there is limited evidence on which to base the recommendation to stop screening. There is confusion among patients and physicians, and other healthcare providers over who to screen and when, and this is exacerbating the already known difficulty accessing healthcare among racial and ethnic minorities, underinsured, and rural populations, but rates of cancer are also rising most rapidly in white women. Recommendations to space or stop screening are often based on the perceived psychological distress of women undergoing testing and the cost of population screening.
Topics: Humans; Female; Aged; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears; Early Detection of Cancer; Papillomavirus Infections; Mass Screening
PubMed: 36924411
DOI: 10.1097/GCO.0000000000000859 -
Acta Cytologica 2022Although the cytological diagnostic criteria for cervical squamous and glandular lesions are established by the Bethesda System for Reporting Cervical Cytology, the...
INTRODUCTION
Although the cytological diagnostic criteria for cervical squamous and glandular lesions are established by the Bethesda System for Reporting Cervical Cytology, the reproducibility of the diagnosis of these lesions has been shown to be variable in previous studies. At best, occasional good kappa (κ) values were reached both inter- and intra-observerly. Generally, consensus on high-grade lesions has been better compared to milder changes.
METHODS
Altogether, 167 conventional Pap smears from 50 patients with histologically confirmed endocervical adenocarcinomas (EAC) and adenocarcinomas in situ (AIS) and from 28 patients with histologically proven high-grade intraepithelial lesions were analyzed by four cytopathologists. Twenty of the smears were later re-evaluated by the same cytopathologists. κ-values between cytopathologists in the categories of squamous versus glandular, negative for intraepithelial lesion or malignancy (NILM), atypical, and preneoplastic/neoplastic were calculated. The diagnostic Pap smears of EAC and AIS with best and worst consensus between observers were then morphologically analyzed.
RESULTS
The reproducibility ranged from poor to substantial. The overall κ-values between the four cytopathologists were 0.412, 0.314, 0.272, and 0.082, respectively, in the categories of preneoplastic/neoplastic, squamous versus glandular, NILM, and atypical. Overall intra-observer κ-values were correspondingly 0.491, 0.616, 0.345, and 0.241. In the diagnostic smears of AIS and EAC, the nuclear size >2 times the normal and nuclear pleomorphism were the commonest features associated with good diagnostic consensus and the lack of nuclear enlargement and degenerative changes were associated with poor consensus.
CONCLUSIONS
The reproducibility of preneoplasia/neoplasia diagnoses was better than that of atypia and NILM both in the inter- and intra-observer part in this study. In the smears from AIS and EAC patients, general neoplasia-associated features were more common in samples with good agreement by the four cytopathologists of the neoplastic nature and the endocervical origin of the lesion.
Topics: Adenocarcinoma in Situ; Carcinoma, Squamous Cell; Female; Humans; Observer Variation; Papanicolaou Test; Reproducibility of Results; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35226896
DOI: 10.1159/000522212 -
Diagnostic Cytopathology Jun 2018The development of the Papanicolaou smear test by Dr. George Nicholas Papanicolaou (1883-1962) is one of the most significant achievements in screening for disease and... (Review)
Review
The development of the Papanicolaou smear test by Dr. George Nicholas Papanicolaou (1883-1962) is one of the most significant achievements in screening for disease and cancer prevention in history. The Papanicolaou smear has been used for screening of cervical cancer since the 1950s. The test is technically straightforward and practical and based on a simple scientific observation: malignant cells have an aberrant nuclear morphology that can be distinguished from benign cells. Here, we review the scientific understanding that has been achieved and continues to be made on the causes and consequences of abnormal nuclear morphology, the basis of Dr. Papanicolaou's invention. The deformed nuclear shape is caused by the loss of lamina and nuclear envelope structural proteins. The consequences of a nuclear envelope defect include chromosomal numerical instability, altered chromatin organization and gene expression, and increased cell mobility because of a malleable nuclear envelope. HPV (Human Papilloma Virus) infection is recognized as the key etiology in the development of cervical cancer. Persistent HPV infection causes disruption of the nuclear lamina, which presents as a change in nuclear morphology detectable by a Papanicolaou smear. Thus, the causes and consequences of nuclear deformation are now linked to the mechanisms of viral carcinogenesis, and are still undergoing active investigation to reveal the details. Recently a statue was installed in front of the Papanicolaou's Cancer Research Building to honor the inventor. Remarkably, the invention nearly 60 years ago by Dr. Papanicolaou still exerts clinical impacts and inspires scientific inquiries.
Topics: Biomarkers, Tumor; Cell Nucleus; History, 20th Century; Humans; Neoplasms; Papanicolaou Test
PubMed: 29663734
DOI: 10.1002/dc.23941 -
Women & Health Feb 2023This study was carried out to determine the effect of fear of COVID-19 on health-seeking behaviors and Pap smear test rates in women. This study was conducted online...
This study was carried out to determine the effect of fear of COVID-19 on health-seeking behaviors and Pap smear test rates in women. This study was conducted online between June and September 2021. Women aged 21-65 years were invited to participate in the study via social media. A total of 396 women comprised the sample for this study. Data were collected the Fear of COVID-19 Scale, and the Health-seeking Behavior Scale. Data were evaluated using descriptive statistics, parametric tests and regression analysis. As a result of the study, 11.1 percent of women were found to have had a Pap smear test during the pandemic period. Fear of COVID-19 was determined to have a positive and significant effect on online health-seeking behavior (t = 7.915, < .001), professional health-seeking behavior ( = 4.503, < .001), traditional health-seeking behavior ( = 6.037, < .001), and general health-seeking behavior( = 8.390, < .001) while it did not have any effect on having a Pap smear test ( > .05). This study showed that although the fear of COVID-19 positively affected health-seeking behaviors in women, the rates of gynecological examination and Pap smear test rates were low during the pandemic.
Topics: Female; Humans; Male; Papanicolaou Test; Vaginal Smears; COVID-19; Fear; Uterine Cervical Neoplasms; Health Knowledge, Attitudes, Practice; Patient Acceptance of Health Care; Mass Screening
PubMed: 36581448
DOI: 10.1080/03630242.2022.2162190 -
International Journal For Equity in... Apr 2016Many evidences illustrate that the Pap smear screening successfully reduces if the cervical cancer could be detected and treated sufficiently early. People with...
BACKGROUND
Many evidences illustrate that the Pap smear screening successfully reduces if the cervical cancer could be detected and treated sufficiently early. People with disability were higher comorbidity prevalence, and less likely to use preventive health care and health promotion activities. There were also to demonstrate that people with visual impairment has less access to appropriate healthcare services and is less likely to receive screening examinations. In Taiwan, there was no study to explore utilization of Pap smear, associated factors and use barriers about Pap smear screening test among women with visual impairment. The purpose is to explore the utilization and barriers of using Pap smear for women with visual impairment in Taiwan. To identify the barriers of women with visual from process of receiving Pap smear screening test.
METHODS
The cross-sectional study was conducted and the totally 316 participators were selected by stratified proportional and random sampling from 15 to 64 year old women with visual impairment who lived in Taipei County during December 2009 to January 2010. The data was been collected by phone interview and the interviewers were well trained before interview.
RESULTS
The mean age was 47.1 years old and the highest percentage of disabled severity was mile (40.2 %). Totally, 66.5 % of participators were ever using Pap smear and 38.9 % used it during pass 1 year. Their first time to accept Pap smear was 38.8 year old. There was near 50 % of them not to be explained by professionals before accepting the Pap smear. For non-using cases, the top two percentage of barriers were "feel still younger" (22.3 %), the second was "there's no sexual experience" (21.4 %). We found the gynecology experiences was key factor for women with visual impairment to use Pap smear, especially the experiences was during 1 year (OR = 4).
CONCLUSIONS
Associated factors and barriers to receive Pap smear screening test for women with visual impairment can be addressed through interventions aimed at improving on cognitions and attitudes for cervical cancer risk factors. Our study would be as a reference resource for erasing the barriers and inequality among the visually disabled women.
Topics: Adolescent; Adult; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Middle Aged; Papanicolaou Test; Preventive Health Services; Uterine Cervical Neoplasms; Vision Disorders
PubMed: 27068132
DOI: 10.1186/s12939-016-0354-4