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International Journal of Environmental... Sep 2022Cervical cancer continues to be a major health problem in developing countries. Educational programs, as well as Pap and HPV screening and vaccination, are important...
BACKGROUND
Cervical cancer continues to be a major health problem in developing countries. Educational programs, as well as Pap and HPV screening and vaccination, are important tools to reduce the morbidity and mortality rates associated with this disease. The objective of this study is to explore the diverse knowledge and perceptions about cervical cancer and the different diagnostic tests for HPV of populations living in the rural parish "El Valle".
METHOD
A qualitative study was conducted through eight focus groups, which included 46 participants from mixed ethnic groups. A phenomenological analysis was performed.
RESULTS
Four topics and seven sub-topics were identified. By analyzing all the narratives, it was possible to identify that the perception of cervical cancer was focused on its severity, secondary to its infectious process and screening periodicity. However, despite the diverse knowledge, indigenous people do not relate it to the human papilloma virus; in addition, there is also certain resistance to undergo the Pap smear test, for reasons such as inaccessibility and its sampling process.
CONCLUSIONS
It is necessary to develop educational programs for the prevention of cervical cancer and to implement diagnostic alternatives to reach populations with precarious accessibility, as well as women who refuse to undergo the Pap smear test.
Topics: Early Detection of Cancer; Ecuador; Female; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Qualitative Research; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 36078764
DOI: 10.3390/ijerph191711053 -
Revista Medica de Chile Aug 2021Cancer is a public health problem among women, but preventive actions are effective.
BACKGROUND
Cancer is a public health problem among women, but preventive actions are effective.
AIM
To outline the reasons and factors associated with abstention from pap smears and mammography examinations among women.
MATERIAL AND METHODS
Using official databases of the WHO and the Ministry of Social Development of Chile, inferential statistical analyses and modeling of abstention through binomial logistic regression were carried out.
RESULTS
Breast and cervical cancer had the highest incidence and mortality among women over 35 years old in Chile, even when there are effective screening methods for their early detection. Abstention is conditioned by personal reasons such as low risk perception. There is a high concomitance of abstention for pap smears and mammography.
CONCLUSIONS
Health promotion actions should encourage women to undergo preventive actions for breast and cervical cancer.
Topics: Adult; Chile; Early Detection of Cancer; Female; Humans; Mammography; Papanicolaou Test; Prevalence
PubMed: 35319701
DOI: 10.4067/s0034-98872021000801150 -
Indian Journal of Cancer 2016Cytology smears and guided biopsies are the most widely used diagnostic standards for cervical cancer (CC) screening in the developing countries.
BACKGROUND
Cytology smears and guided biopsies are the most widely used diagnostic standards for cervical cancer (CC) screening in the developing countries.
AIM
To evaluate the performance of conventional cytology in estimating the presence and grade of cervical disease against the reference standard of histopathology.
SETTINGS AND DESIGN
After primary screening for CC, directed biopsies were performed and compared with histopathology results.
MATERIALS AND METHODS
Papanicolaou (Pap) smears and biopsies from 3194 women in the age group of 14-98 years were included. Cytology results were provided by doctors who performed the cervical biopsies.
STATISTICAL ANALYSIS
The accuracy of Pap smear was measured by sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) calculated using the statistical analysis program PSPP 0.7.8.
RESULTS
The sensitivity of conventional cytology (Pap smear) for women with low-grade cervical intraepithelial neoplasia or less serious lesions (CIN1-) was 93% and specificity was 73%. The sensitivity and specificity of cytology for women with high-grade cervical intraepithelial neoplasia or cancer (CIN2+) was 64% and 84%, respectively.
CONCLUSION
Cytology is a sufficiently sensitive test for detection of cervical lesions and can be used as a primary testing tool to triage.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Humans; Middle Aged; Papanicolaou Test; Squamous Intraepithelial Lesions of the Cervix; Young Adult
PubMed: 27146747
DOI: 10.4103/0019-509X.180825 -
BMC Women's Health Feb 2022Nigeria has a low uptake of cervical cancer screening and is one of the five countries that represent over half of the global burden of deaths from cervical cancer....
INTRODUCTION
Nigeria has a low uptake of cervical cancer screening and is one of the five countries that represent over half of the global burden of deaths from cervical cancer. Social marketing principles can be used to design and implement interventions to increase uptake of cervical cancer screening. This study assessed the effect of a social marketing intervention on the knowledge, attitude, and uptake of pap smear among women residing in an urban slum in Lagos State, Nigeria.
MATERIALS AND METHODS
This was a quasi-experimental study. The intervention arm consisted of 140 women recruited from Ago-Egun Bariga community and the control arm consisted of 175 women recruited from Oto-Ilogbo extension community. Social marketing intervention was instituted in the intervention group. Data analysis was done using IBM SPSS Statistics version 20 and Stata version 16.0. Between groups comparisons and within groups comparisons were done using bivariate analysis with Chisquare, Students t test and Paired t test as appropriate.
RESULTS
In both the intervention and control groups, the mean knowledge score of cervical cancer was low at baseline (0.0 ± 0.3 and 0.1 ± 0.9 respectively). In the intervention group, there was a significant increase in mean knowledge score to 15.1 ± 3.7, post-intervention (p < 0.001). In both groups, the mean attitude score of cervical cancer was low at baseline (27.1 ± 0.8 in the intervention group and 27.2 ± 1.4 in the control group). In the intervention group, there was a significant increase in mean attitude score to 36.5 ± 4.8, post-intervention (p < 0.001). In both the intervention and control groups, uptake of pap smear was low at baseline (0.0% and 0.6%, respectively). In the intervention group, there was a significant increase in uptake of pap smear to 84.3%, post-intervention (p < 0.001). There was no statistically significant change in knowledge, attitude or uptake of pap smear in the control group, post-intervention.
CONCLUSION
This study demonstrated that social marketing intervention can be successful in improving knowledge, attitude, and also the uptake of pap smear, even in settings where these are abysmally low. It is recommended that social marketing intervention be employed as a strategy for improving cervical cancer screening among women residing in slums.
Topics: Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Nigeria; Papanicolaou Test; Poverty Areas; Social Marketing; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35164717
DOI: 10.1186/s12905-022-01620-5 -
Medical Archives (Sarajevo, Bosnia and... Oct 2020Cervical cancer can be successfully prevented by timely detection of changes that precede it such as atypical (ASC-H) and high grade squamous lesions (HSIL). (Comparative Study)
Comparative Study
INTRODUCTION
Cervical cancer can be successfully prevented by timely detection of changes that precede it such as atypical (ASC-H) and high grade squamous lesions (HSIL).
AIM
To investigate the correlation between Pap smear and colposcopy in the detection of premalignant and malignant cervical lesions based on a pathohistological finding.
METHODS
In a retrospective study 118 patients with HSIL and ASC-H findings were examined. A Pap smear, colposcopic examination and cervical canal biopsy were performed. The study was conducted at the Gynecological Center "Dr Mahira Jahic" Tuzla and the Clinical Center Tuzla, Department of Gynecology and Obstetrics.
RESULTS
1049 abnormal Pap tests were analyzed, ASCUS in 51,8% (N-544), LSIL 32,1% (N-337), HSIL 7,7% (N-81) and ASC-H 3,5% (N-37), AGC 4,8% (N-51). The mean age of the subjects with the abnormal Pap test was 46.33 ± 3.2. The age of patients with ASCUS lesion was 38,6 , LSIL 41,0, ASC-H was 47,3 , HSIL (CIN II and CIN III) 45,8 , while patients with CIS were 51,2 years. Pathological histology HSIL confirmed a high grade lesion in 67,7% (CIN II, CIN III and CIS) (N-55), in 32% (N-26) a lower grade CIN I in 18,5% and chronic cervicitis in 13,5% (N-11). In ASC-H lesion pathohistological HSIL was found in 13,5% (N-5), CIN I 13,5% (N-5) and chronic cervicitis 48,6 % (N-18). Abnormal colposcopic imaging with HSIL lesion was found in 72,9% (N-69), in 8,6% (N-7) was unsatisfactory and in 18,5% (N-15) the colposcopic finding was normal. In ASC-H lesions, abnormal colposcopic imaging was found in 40,5% (N-15), unsatisfactory findings in 10,8% (N-4), and normal findings in 48,6% (N-18).
CONCLUSION
Colposcopy has proven to be better method than cytology with an accuracy of 72,9% in high-grade lesion such as HSIL and ASC-H.
Topics: Adult; Atypical Squamous Cells of the Cervix; Bosnia and Herzegovina; Colposcopy; Female; Histological Techniques; Humans; Middle Aged; Neoplasms; Papanicolaou Test; Retrospective Studies; Squamous Intraepithelial Lesions; Uterine Cervical Dysplasia
PubMed: 33424094
DOI: 10.5455/medarh.2020.74.381-383 -
Acta Cytologica 2021Gastric-type endocervical adenocarcinoma (GAS) is a recently described, uncommon, and aggressive tumor with distinct morphologic features and HPV-independent etiology....
OBJECTIVE
Gastric-type endocervical adenocarcinoma (GAS) is a recently described, uncommon, and aggressive tumor with distinct morphologic features and HPV-independent etiology. Data on GAS in liquid-based cytology (LBC) Papanicolaou (Pap) test preparations from a North American patient population are scant. We systematically assessed the cytomorphologic characteristics of GAS in LBC from patients in Ontario and examined if glandular cell nuclear area could represent a readily assessable feature which may aid in GAS detection.
STUDY DESIGN
Pap test slides preceding the diagnosis of GAS were retrieved locally or requested from outside laboratories. A structured review of 15 cytomorphologic features was performed using the available LBC Pap test slides of GAS and a set of usual-type endocervical adenocarcinomas (UEA). Morphometry of the glandular cell nuclear area was performed, and normalized values were compared to UEA and benign endocervical cells.
RESULTS
At least 1 Pap test (5 ThinPrep®, 11 SurePath®, and 1 direct smear) was available for 14 patients. Original LBC Pap test diagnoses were negative for intraepithelial lesion or malignancy (NILM) (7), adenocarcinoma/carcinoma (6), atypical glandular cells (2), and adenocarcinoma in situ (1). Review detected abnormal glandular cells in 6/7 NILM cases. Honeycomb-like sheets, nuclear enlargement, and microvesicular cytoplasm were the single most common architectural, nuclear, and cytoplasmic features, respectively. Microvesicular cytoplasm (100 vs. 17%), honeycomb-like sheets (87 vs. 8%), prominent nucleoli (93 vs. 25%), and anisonucleosis (93 vs. 50%) were most discriminatory for GAS versus UEA, respectively. Yellow mucin, intranuclear cytoplasmic pseudoinclusions, and goblet/Paneth-like cells were uncommon, but unique for GAS. Glandular cell nuclear area normalized to neutrophils was found to be significantly increased in GAS compared to benign endocervical cells.
CONCLUSIONS
GAS is under-recognized and may mimic reactive endocervical cells. Awareness of the tumor type and its cytomorphology is critical for early detection. Identification of glandular cells with uniform nuclear enlargement in conjunction with any of the other cytologic features may help avoid false-negative Pap results. Neutrophils may serve as convenient size reference and visual aid.
Topics: Adenocarcinoma; Adult; Aged; Cell Nucleus; Cervix Uteri; Epithelial Cells; Female; Humans; Middle Aged; Papanicolaou Test; Papillomaviridae; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 33152741
DOI: 10.1159/000511003 -
Asian Pacific Journal of Cancer... 2016Cervical cancer is the fourth common cancer among women worldwide. Pap smear screening has resulted in deceasing incidence of cervical cancer in developed countries but...
Cervical cancer is the fourth common cancer among women worldwide. Pap smear screening has resulted in deceasing incidence of cervical cancer in developed countries but low uptake of Pap smear screening among women in developing countries is still a public health challenge. The aim of this cross-sectional study was to assess the relationship between self-efficacy and timely uptake of Pap smear among Iranian women. A total of 580 married women referred to primary health care centers covered administratively by Shahid Beheshti University of Medical Sciences in Tehran were administered a questionnaire by trained staff. Data were analyzed with SPSS (version 16) software, using univariate and multivariate logistic regression. The mean age for participants was 33.1±8.8 years. There was a significant association between self-efficacy and Pap smear screening (P<0.01). There was also a positive correlation between duration of marriage and husband's education with Pap smear uptake (P<0.01). In univariate analysis, there was a significant association between Pap smear uptake and level of self-efficacy (OR = 15.3 for intermediate and OR=7.4 for good level), duration of marriage (OR = 5.7 for 5-14 years and OR=10.4 for more than 15), age (OR =2.7 for 27-34 years and OR=7.4 for more than 35 years) and husband education level (OR=2.3 for more than 12 years of education). In multivariate analysis, significant associations persisted between Pap smear uptake and self-efficacy (OR = 23.8; 95% CI: 8.7, 65.5), duration of marriage (OR = 5.9; 95% CI: 2.8, 12.2), age (OR = 3.9; 95% CI: 1.2, 12.9) and husband's education (OR = 2.5; 95% CI: 2.0, 10.3). Efforts are needed to increase women's knowledge about cervical cancer and improve their self-efficacy and perceptions of the Pap smear screening in order to reduce cervical cancer incidence and mortality rates.
Topics: Adolescent; Adult; Cross-Sectional Studies; Female; Follow-Up Studies; Health Knowledge, Attitudes, Practice; Humans; Iran; Mass Screening; Papanicolaou Test; Prognosis; Self Efficacy; Surveys and Questionnaires; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult
PubMed: 27165236
DOI: 10.7314/apjcp.2016.17.s3.263 -
Indian Journal of Cancer 2022">Cervical cancer in India accounts for one-fifth of the global burden. Well-defined precancerous stages help early detection of the disease. Apart from human...
BACKGROUND
">Cervical cancer in India accounts for one-fifth of the global burden. Well-defined precancerous stages help early detection of the disease. Apart from human papillomavirus, the risk factors include age, education, occupation, early age at marriage and first delivery, abortions, and multiple sexual partners. Prevalence and risk factors for cervical squamous intraepithelial lesions (SIL) among women by Pap smear screening in south India were analyzed through a cross-sectional study.
METHODS
">Women from rural and urban area were motivated by local accredited social health activists to attend pre-fixed Pap smear clinics in government hospitals. Pap smears collected in these clinics were taken to the Regional Cancer Centre, Thiruvananthapuram, processed, and cytology reports were prepared. Multiple logistic regression analysis was used to identify risk factors for SIL and high-grade SIL (HSIL).
RESULTS
">The number of SIL was 67 out of 10,580 and HSIL was 39. Having higher education (Odds Ratio, OR:0.05(95% Confidence Interval, CI: 0.01-0.2), being married but living single (OR : 5.3, 95%CI:2.4-11.5), Having >2 abortions (OR:21, 95% CI:4.5-24), having younger age at delivery (OR : 0.1, 95% CI:0.01-0.3) and having unhealthy cervix (OR: 16.4, 95% CI:6.2-42.7) were the factors found to be the associated risk factors in multiple regression analysis.
CONCLUSION
">Pap smear screening can be focused on women with risk factors such as low education, married but living single, having >2 abortions, younger age at delivery, and unhealthy cervix on per speculum examination.
Topics: Cross-Sectional Studies; Female; Humans; India; Papanicolaou Test; Papillomavirus Infections; Prevalence; Risk Factors; Squamous Intraepithelial Lesions; Uterine Cervical Neoplasms; Vaginal Smears; Uterine Cervical Dysplasia
PubMed: 33753607
DOI: 10.4103/ijc.IJC_699_19 -
Revista Brasileira de Enfermagem 2016
Review
Topics: Female; Health Education; Humans; Papanicolaou Test; Patient Compliance; Uterine Cervical Neoplasms
PubMed: 27280579
DOI: 10.1590/0034-7167.2016690226i -
The Pan African Medical Journal 2022despite the availability of screening facilities in South Africa, cervical cancer prevalence and mortality is still high. Most women present to the health facilities at...
INTRODUCTION
despite the availability of screening facilities in South Africa, cervical cancer prevalence and mortality is still high. Most women present to the health facilities at an advanced stage of disease. This study aimed to determine the prevalence of cervical abnormalities using the revised Bethesda System among rural women in KwaZulu-Natal, South Africa.
METHODS
this was a cross-sectional descriptive study using a retrospective medical record review method to collect data on Pap smears from three rural clinics in KwaZulu-Natal. Clinical data and cytology reports were obtained for the years January 2016 to January 2019. Women aged 18-65 years were included.
RESULTS
of 246 randomly-selected medical records, 245 Pap smears were analysed. Half (47.8%) of the women were in the age group 30-44 years. HIV, as a risk factor, was found in 41.2% of the women. A total of 48.6% Pap smears were negative for malignancy. Of the 49.8% abnormal screened results, 25.7% women had low-grade squamous intraepithelial lesion, 13.9% high-grade squamous intraepithelial lesion (HSIL), 8.6% atypical squamous cells of undetermined significance, and 1.6% squamous cell carcinoma (SCC). All SCC cases were found in HIV-infected patients. HSIL and SCC were less common among patients younger than 30 years.
CONCLUSION
this study´s results accentuate the importance of well-organised cervical screening programmes. Cervical screening, through Pap smears, is a useful, non-invasive and cost-effective method for early detection of pre-invasive lesions. Women, especially those over 30 years, should be educated on the importance of Pap smears and encouraged to uptake the test.
Topics: Cross-Sectional Studies; Early Detection of Cancer; Female; HIV Infections; Humans; Male; Papanicolaou Test; Prevalence; Retrospective Studies; South Africa; Squamous Intraepithelial Lesions; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35432696
DOI: 10.11604/pamj.2022.41.110.27222