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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 -
Asian Pacific Journal of Cancer... Oct 2021Liquid-based preparation (LBP) cytology is commonly used in most laboratories these days due to its convenience and reliable results for the cervical cancer screening...
UNLABELLED
Liquid-based preparation (LBP) cytology is commonly used in most laboratories these days due to its convenience and reliable results for the cervical cancer screening program. The PathTezt™ Liquid-based Pap smear is a second-generation LBP, which uses a filter-based concentration technique in processing the sample.
OBJECTIVE
This study was done to evaluate the cellular fixation, morphology, quality of smear in gynae cytology, and diagnostic interpretation of cervical cytological smears produced by the PathTezt liquid-based processor.
MATERIALS AND METHODS
A total of 400 pap smear samples were taken and processed using the PathTezt 2000 processor. The slides were evaluated in terms of sample adequacy, percentage of the circle covered by epithelial cells, cellular distribution, obscuring factors, and cell fixation.
RESULTS
About 95.25% (381) of the samples were satisfactory for the evaluation. In 19 (4.75%) of the samples, epithelial cells covered less than 50% of the circle. A sample with good cellular distribution was seen in 92% of the cases, while 354 (88.5%) samples showed minimal inflammatory background. Almost all the smears (95.75%) had no erythrocytes in the background. All smears showed good quality fixation features toward nuclear, cytoplasm, and microorganisms. The total performance rate was 99%.
CONCLUSION
Although the PathTezt liquid-based processor is still new compared to other first-generation LBP, the smears produced by this method were of high quality and it was cost-effective.
Topics: Adult; Aged; Cervix Uteri; Cost-Benefit Analysis; Epithelial Cells; Female; Humans; Malaysia; Middle Aged; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult
PubMed: 34711003
DOI: 10.31557/APJCP.2021.22.10.3261 -
Nursing Open May 2022The study examines limiting factors associated with cervical cancer Pap smear screening among participants of reproductive age attending a healthcare facility in Namibia.
AIM
The study examines limiting factors associated with cervical cancer Pap smear screening among participants of reproductive age attending a healthcare facility in Namibia.
DESIGN
A cross-sectional descriptive and exploratory study was conducted.
METHODS
The data were collected using a face-to-face interview (qualitative) and a structured questionnaire (quantitative). A total of 49 participants (10 qualitative and 39 quantitative) aged 17-45 years participated in the study.
RESULTS
The study revealed that 80% of participants have limited knowledge of cervical cancer, while 49% have never done the test before and 8% were not informed of the screening and risk of the disease. Furthermore, 49% of participants responded that the screening fees are not affordable. Meanwhile, all participants (100%) complained of the long waiting period. Other main barriers for not screening were missed announcements and unsuitable time allocation. Knowledge on cervical cancer and turn-up for Pap smear screening test was low among participants of reproductive age.
Topics: Cross-Sectional Studies; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Papanicolaou Test; Perception; Uterine Cervical Neoplasms
PubMed: 35243808
DOI: 10.1002/nop2.1196 -
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 -
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 -
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 -
Revista Brasileira de Enfermagem 2023to identify, map and describe characteristics of educational interventions for cervical cancer prevention in adult women. (Review)
Review
OBJECTIVES
to identify, map and describe characteristics of educational interventions for cervical cancer prevention in adult women.
METHODS
a scoping review conducted on eleven databases and the gray literature, including studies that described educational interventions aimed at preventing cervical cancer in adult women.
RESULTS
thirty-three articles with 151,457 participants were analyzed. The most used educational strategies were participatory discussions and educational leaflets. Most of the interventions took place in a single session, ranging from 40 to 60 minutes. The most used theoretical model in interventions to improve women's compliance with Pap smear was the Health Belief Model.
CONCLUSIONS
group discussions, lectures and educational brochures can increase knowledge and reduce barriers to cervical cancer prevention. Theory-based and culturally sensitive interventions can have a positive impact on women's health.
Topics: Adult; Female; Humans; Uterine Cervical Neoplasms; Early Detection of Cancer; Health Knowledge, Attitudes, Practice; Papanicolaou Test; Patient Acceptance of Health Care
PubMed: 38018622
DOI: 10.1590/0034-7167-2023-0018 -
BMC Women's Health Jun 2020Though obesity is associated with some malignancies, its association with cervical cancer is still inconclusive. This study was aimed at determining if there was an... (Comparative Study)
Comparative Study
BACKGROUND
Though obesity is associated with some malignancies, its association with cervical cancer is still inconclusive. This study was aimed at determining if there was an association between obesity and cervical epithelial cell abnormalities (CEA).
METHODS
This was a cross-sectional comparative study of obese and non-obese women at the Cervical Cancer Screening Clinic, University of Nigeria Teaching Hospital (UNTH), Enugu between January, 2012 and June, 2013. The participants whose body mass index (BMI) were ≥ 30 kg/m were classified as obese (200 women) while those whose BMI were < 30 kg/m were classified as non-obese (200 women) and the two groups were consecutively recruited at the ratio of 1:1. Pap smear cytology, random blood sugar (RBS) and human immune-deficiency virus (HIV) screening was done for all the participants. Data was analyzed with SPSS version 20. Categorical variables were analyzed using McNemar's test and Chi-squared test. Logistic regression analysis was used to determine the influence of socio-demographic characteristics on cervical epithelial cell abnormalities. The level of significance was set at ≤0.05.
RESULTS
Among the obese women, 152(76%) had negative for intra-epithelial lesion or malignancy (NILM) while 48(24%) had cervical epithelial cell abnormalities (CEA). Also 182(91%) non-obese women had NILM while the remaining 18(9%) had CEA. The prevalence of CEA among all the study participants was 16.5%. There was an association between obesity and CEA[OR (95%CI) = 1.353(1.013-1.812); P-value = 0.04].CEA were significantly more common among women who were 40 years and above and single/separated women as well as widows (P-value = < 0.05).
CONCLUSION
There was an association between obesity and CEA. This underscores the need for a positive behavioural change among women in order to stem the tide of this public health problem.
Topics: Cross-Sectional Studies; Early Detection of Cancer; Female; Humans; Nigeria; Obesity; Papanicolaou Test; Pregnancy; Prevalence; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 32517800
DOI: 10.1186/s12905-020-00984-w -
The Medical Journal of Malaysia Feb 2019Cervical cancer is among the most common cancers in women worldwide. The Pap smear test is the primary screening procedure used to detect abnormal cells that may develop...
INTRODUCTION
Cervical cancer is among the most common cancers in women worldwide. The Pap smear test is the primary screening procedure used to detect abnormal cells that may develop into cancer.
OBJECTIVES
This study analysed the knowledge, attitudes and practices of working women in Kedah state, Malaysia, about cervical cancer and Pap smear tests and the associations of knowledge, attitudes and practices with socio-demographic factors.
METHODS
This cross-sectional questionnaire study analysed knowledge, attitudes and practices among 210 female entrepreneurs who received funding from Amanah Ikhtiar Malaysia (AIM) in Kedah state. Women were included if they were married or previously married, aged 20-65 years and had not been diagnosed with cervical cancer.
RESULTS
Most subjects could not recall common symptoms of cervical cancer, such as bleeding between periods, and did not know or were unsure of the suitable age for Pap smear tests and the interval between tests. Although most subjects agreed that Pap smear tests were necessary, some gave priority to other issues. About half (55.2%) had undergone Pap smear tests, but only 38.6% had been tested within the previous five years. Use of hormonal contraceptives, higher knowledge score, and higher attitude score were associated with Pap smear testing within the previous 5 years.
CONCLUSIONS
Knowledge regarding cervical cancer and Pap smear testing and attitudes toward testing were poor among most participants. These factors were significantly associated with lack of actual testing.
Topics: Adult; Aged; Cross-Sectional Studies; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Middle Aged; Papanicolaou Test; Surveys and Questionnaires; Uterine Cervical Neoplasms; Young Adult
PubMed: 30846655
DOI: No ID Found -
Acta Cytologica 2015The history of 'The Bethesda System' for reporting cervical cytology goes back almost 3 decades. This terminology and the process that created it have had a profound... (Review)
Review
The history of 'The Bethesda System' for reporting cervical cytology goes back almost 3 decades. This terminology and the process that created it have had a profound impact on the practice of cervical cytology for laboratorians and clinicians alike. The Bethesda conferences and their ensuing output have also set the stage for standardization of terminology across multiple organ systems, including both cytology and histology, have initiated significant research in the biology and cost-effective management for human papillomavirus-associated anogenital lesions, and, finally, have fostered worldwide unification of clinical management for these lesions. Herein, we summarize the process and rationale by which updates were made to the terminology in 2014 and outline the contents of the new, third edition of the Bethesda atlas and corresponding website.
Topics: Female; Humans; Neoplasm Grading; Observer Variation; Papanicolaou Test; Practice Guidelines as Topic; Predictive Value of Tests; Reproducibility of Results; Terminology as Topic; Uterine Cervical Neoplasms; Vaginal Smears; Uterine Cervical Dysplasia
PubMed: 25997404
DOI: 10.1159/000381842