-
Journal of Medical Screening Jun 2021Breast and cervical cancers are screen-detectable; yet, challenges exist with ensuring uptake of mammography and Pap smear. Family, a central factor in developing... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Breast and cervical cancers are screen-detectable; yet, challenges exist with ensuring uptake of mammography and Pap smear. Family, a central factor in developing knowledge to carry out health promotion behaviors, may be an asset to improving intention to screen among non-adherent women from underrepresented minority groups. We explored familial cancer; communication; and breast and cervical screening intention among non-adherent Black, Latina, and Arab women in the United States who participated in a randomized controlled trial of the Kin Keeper Cancer Prevention Intervention study. The intervention was a culturally-targeted breast and cervical cancer literacy tool for Black, Latina, and Arab women, consisting of two family-focused education sessions on the cancers, their screening guidelines, and risk-reducing health-related behaviors.
METHODS
For this secondary analysis, we assessed family cancer history, family communication, and screening intention for breast and cervical cancer in age-eligible, non-adherent participants. Descriptive statistics examined sample characteristics of the intervention and control groups. Odds ratios were estimated from logistic regression modeling to assess the intervention and sample characteristic effects on screening intention.
RESULTS
Of the 516 participants, 123 and 98 were non-adherent to breast and cervical cancer screening, respectively. The intervention (OR = 1.95 for mammography; OR = 1.62 for Pap smear) and highly communicative (OR = 2.57 for mammography; OR = 3.68 for Pap smear) families reported greater screening intention. Family history of cancer only increased screening intention for mammography (OR = 2.25).
CONCLUSION
Family-focused approaches supporting communication may increase breast and cervical cancer screening intention among non-adherent, underrepresented minority groups.
Topics: Breast Neoplasms; Communication; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Intention; Mammography; Mass Screening; Papanicolaou Test; United States; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 32393152
DOI: 10.1177/0969141320920900 -
BMC Women's Health Aug 2021Cervical cancer is considered treatable as long as it is detected early and managed effectively. Pap smear test is a screening tool that plays an important role in the...
OBJECTIVE
Cervical cancer is considered treatable as long as it is detected early and managed effectively. Pap smear test is a screening tool that plays an important role in the early detection, prevention and can prevent any early cervical cell changes from becoming cancer. This study aims to survey the effect of educational programs based on beliefs, subjective norms, and perceived behavior control on doing the pap-smear test in a sample of Iranian women.
MATERIALS AND METHODS
This experimental interventional study was performed on 300 women admitted to Fasa City, Fars Province, Iran health centers in 2018-2019. A questionnaire consisting of demographic information, knowledge, Health Belief Model, and Theory of Planned Behavior constructs were used to measure on doing of Pap smear test in women before and after 6 months' educational intervention.
RESULTS
The results revealed that 6 months after the intervention, 108 women (72%) in the experimental group and only 9 women (6%) in the control group received the Pap smear test.
CONCLUSIONS
The current research results revealed that education based on the combination of the health Belief model and theory of planned behavior might be promoting participation and an increasing rate of receiving Pap smear tests in women.
Topics: Behavior Control; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Iran; Papanicolaou Test
PubMed: 34362375
DOI: 10.1186/s12905-021-01419-w -
Indian Journal of Cancer 2018Cervical cancer is the fourth leading cause of cancer in women in the world and it is the second most common cancer in women 15-44 years of age. Strict implementation of...
BACKGROUND
Cervical cancer is the fourth leading cause of cancer in women in the world and it is the second most common cancer in women 15-44 years of age. Strict implementation of screening programs has led to a large decrease in cervical cancer incidence and mortality in the developed countries. In contrast, cervical cancer remains largely uncontrolled in high-risk developing countries because of ineffective or no screening programs. Conventional Pap smear method has been the mainstay of most of the screening programs for many decades. However, this technique is not without limitations, and the sensitivity and specificity of cervical cytology are relatively low. To overcome the limitations of conventional Pap smear (CPS), liquid-based cytology (LBC) was introduced in 1990s as a better tool for processing cervical samples.
OBJECTIVES
This study was undertaken to compare CPS with liquid-based methods, to assess the effectiveness and feasibility of LBC over CPS in our setting, and also to evaluate the prevalence of human papillomavirus (HPV) in our population.
MATERIALS AND METHODS
This study was conducted in Gynecological Oncology Unit of Regional Cancer Center at Indira Gandhi Institute of Medical Sciences, Patna, Bihar. About 310 women were enrolled in this study and the sample was taken for both conventional cytology and LBC. The smears were studied in detail and were interpreted as per the Bethesda system of reporting Pap smears. The results were compared and analyzed statistically.
RESULTS
Unsatisfactory smears were more commonly reported by conventional method (7.1%) than with liquid-based method (1.61%), and this difference is statistically significant. There was no difference in the detection of epithelial cell abnormalities using both the methods. HPV DNA for high-risk oncogenic strains (16 and 18) was detected in 6.45% of women in this study.
CONCLUSION
LBC has been found to be more superior to conventional smears only with respect to lesser number of unsatisfactory smears, but considering the economic implications of LBC, conventional Pap is more feasible in our setting.
Topics: Adolescent; Adult; Cytodiagnosis; Female; Humans; India; Mass Screening; Papanicolaou Test; Tertiary Care Centers; Uterine Cervical Neoplasms; Young Adult
PubMed: 30147099
DOI: 10.4103/ijc.IJC_352_17 -
African Journal of Primary Health Care... Oct 2019Cervical cancer is the most common form of cancer in black women in South Africa and has almost a 60% mortality rate. However, adherence to cervical screening programmes...
BACKGROUND
Cervical cancer is the most common form of cancer in black women in South Africa and has almost a 60% mortality rate. However, adherence to cervical screening programmes of black women living in rural South Africa is not universal.
AIM
The aim of this study was to gain a better understanding of rural Zulu women's knowledge of and attitudes towards Pap smear tests, and their reasons for participation or non-compliance with cervical screening.
SETTING
This study was conducted at the gynaecology and antenatal clinics in a secondary referral hospital in rural KwaZulu-Natal.
METHODS
A hospital-based cross-sectional study was undertaken in the form of a semi-structured patient questionnaire survey with open and closed questions. The responses to the open-ended questions were manually analysed by the authors using a thematic approach. Outcome measures included whether the woman had a previous Pap smear, her understanding of the cervical screening programme and causes of cervical cancer.
RESULTS
This study included a total analysis of 234 responses. The mean age was 29 years (s.d. = 8.3 years). Overall, 32.5% of women had previously had a Pap smear. Among the responders, 33.3% were human immunodeficiency virus (HIV)-positive and 53.0% were HIV-negative. Only 19.2% of women understood that a Pap smear was related to screening for cervical cancer.
CONCLUSIONS
This study illustrated a poor understanding of cervical screening, which may result in the low level of uptake of Pap smear reported; this is particularly concerning in HIV-positive women, who are at higher risk of developing cervical cancer. Urgent and extensive public health campaigning is required within rural South Africa to improve cervical screening uptake and decrease cervical cancer mortality.
Topics: Adolescent; Adult; Aged; Black People; Contraception; Cross-Sectional Studies; Early Detection of Cancer; Female; HIV Infections; Health Knowledge, Attitudes, Practice; Humans; Middle Aged; Papanicolaou Test; Rural Population; Socioeconomic Factors; South Africa; Uterine Cervical Neoplasms; Young Adult
PubMed: 31588773
DOI: 10.4102/phcfm.v11i1.1994 -
Clinical Epigenetics 2016The Pap smear has remained the foundation for cervical cancer screening for over 70 years. With advancements in molecular diagnostics, primary high-risk human...
BACKGROUND
The Pap smear has remained the foundation for cervical cancer screening for over 70 years. With advancements in molecular diagnostics, primary high-risk human papillomavirus (hrHPV) screening has recently become an accepted stand-alone or co-test with conventional cytology. However, both diagnostic tests have distinct limitations. The aim of this study was to determine the association between HPV genotypes and cellular epigenetic modifications in three grades of cervical cytology for screening biomarker discovery.
METHODS
This prospective, cross-sectional study used residual liquid-based cytology samples for HPV genotyping and epigenetic analysis. Extracted DNA was subjected to parallel polymerase chain reactions using three primer sets (MY09/11, FAP59/64, E6-E7 F/B) for HPV DNA amplification. HPV+ samples were genotyped by DNA sequencing. Promoter methylation of four candidate tumor suppressor genes (adenylate cyclase 8 (ADCY8), cadherin 8, type 2 (CDH8), MGMT, and zinc finger protein 582 (ZNF582)) out of 48 genes screened was quantified by bisulfite-pyrosequencing of genomic DNA. Independent validation of methylation profiles was performed by analyzing data from cervical cancer cell lines and clinical samples from The Cancer Genome Atlas (TCGA).
RESULTS
Two hundred seventy-seven quality cytology samples were analyzed. HPV was detected in 31/100 (31 %) negative for intraepithelial lesion or malignancy (NILM), 95/100 (95 %) low-grade squamous intraepithelial lesion (LSIL), and 71/77 (92 %) high-grade squamous intraepithelial lesion (HSIL) samples. The proportion of IARC-defined carcinogenic HPV types in sequenced samples correlated with worsening grade: NILM 7/29 (24 %), LSIL 53/92 (58 %), and HSIL 65/70 (93 %). Promoter methylation of ADCY8, CDH8, and ZNF582 was measured in 170 samples: NILM (N = 33), LSIL (N = 70), and HSIL (N = 67) also correlated with worsening grade. Similar hypermethylation patterns were found in cancer cell lines and TCGA samples. The combination of four biomarkers, i.e., HPV genotype and three-gene promoter methylation, predicted HSIL (AUC 0.89) better than HPV alone (AUC 0.74) by logistic regression and probabilistic modeling.
CONCLUSIONS
HPV genotype and DNA methylation of ADCY8, CDH8, and ZNF582 are correlated with cytological grade. Collectively, these biomarkers may serve as a molecular classifier of Pap smears.
Topics: Adenylyl Cyclases; Adult; Cadherins; Cell Line, Tumor; Cross-Sectional Studies; DNA Methylation; DNA, Viral; Early Detection of Cancer; Female; Genotype; Humans; Kruppel-Like Transcription Factors; Middle Aged; Neoplasm Grading; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Promoter Regions, Genetic; Prospective Studies; Sequence Analysis, DNA; Squamous Intraepithelial Lesions of the Cervix; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult; Uterine Cervical Dysplasia
PubMed: 27651839
DOI: 10.1186/s13148-016-0263-9 -
Indian Journal of Dental Research :... 2016Many pathogenic fungi fluoresce in hematoxylin and eosin stained sections, and Papanicolaou (PAP)-stained smears under ultraviolet illumination. In theory, this...
BACKGROUND
Many pathogenic fungi fluoresce in hematoxylin and eosin stained sections, and Papanicolaou (PAP)-stained smears under ultraviolet illumination. In theory, this phenomenon could aid in the diagnosis of common fungal infections without the delay which is usually associated with special stains.
OBJECTIVE
To evaluate the role of fluorescence as a rapid screening technique for oral infections caused by Candida organisms in exfoliative smears of oral candidiasis.
MATERIALS AND METHODS
Two smears and one swab were collected from each of 62 clinically diagnosed cases of oral candidiasis. Smears were stained with (PAP) and periodic acid-Schiff stain (PAS). Both smears were evaluated under light microscopy (LM). Later, PAP smears were observed under fluorescent microscopy (PAP-FM). The swab was inoculated on Sabouraud's agar plate. Each technique was evaluated for sensitivity and specificity.
RESULTS
It was found that the PAS-stained smears were more reliable for detection of Candida species than other methods (sensitivity = 100%; specificity = 66.7%). The PAP-LM and PAP-FM showed less sensitivity (67.9% and 85.7%) and specificity (66.7% and 33.3%), respectively. Combined results of both light and fluorescent microscopy of PAP (LM + FM) showed increased sensitivity (89.3%) but reduced specificity (16.7%).
CONCLUSION
PAP autofluorescence is less sensitive than PAS, still it accentuates the distinct morphological features of Candida.
Topics: Candida; Candidiasis, Oral; Humans; Hyphae; Microscopy; Microscopy, Fluorescence; Papanicolaou Test; Periodic Acid-Schiff Reaction; Sensitivity and Specificity; Staining and Labeling
PubMed: 28169259
DOI: 10.4103/0970-9290.199592 -
Scientific Reports Jul 2021Cervical cancer affects more than 0.5 million women annually causing more than 0.3 million deaths. Detection of cancer in its early stages is of prime importance for...
Cervical cancer affects more than 0.5 million women annually causing more than 0.3 million deaths. Detection of cancer in its early stages is of prime importance for eradicating the disease from the patient's body. However, regular population-wise screening of cancer is limited by its expensive and labour intensive detection process, where clinicians need to classify individual cells from a stained slide consisting of more than 100,000 cervical cells, for malignancy detection. Thus, Computer-Aided Diagnosis (CAD) systems are used as a viable alternative for easy and fast detection of cancer. In this paper, we develop such a method where we form an ensemble-based classification model using three Convolutional Neural Network (CNN) architectures, namely Inception v3, Xception and DenseNet-169 pre-trained on ImageNet dataset for Pap stained single cell and whole-slide image classification. The proposed ensemble scheme uses a fuzzy rank-based fusion of classifiers by considering two non-linear functions on the decision scores generated by said base learners. Unlike the simple fusion schemes that exist in the literature, the proposed ensemble technique makes the final predictions on the test samples by taking into consideration the confidence in the predictions of the base classifiers. The proposed model has been evaluated on two publicly available benchmark datasets, namely, the SIPaKMeD Pap Smear dataset and the Mendeley Liquid Based Cytology (LBC) dataset, using a 5-fold cross-validation scheme. On the SIPaKMeD Pap Smear dataset, the proposed framework achieves a classification accuracy of 98.55% and sensitivity of 98.52% in its 2-class setting, and 95.43% accuracy and 98.52% sensitivity in its 5-class setting. On the Mendeley LBC dataset, the accuracy achieved is 99.23% and sensitivity of 99.23%. The results obtained outperform many of the state-of-the-art models, thereby justifying the effectiveness of the same. The relevant codes of this proposed model are publicly available on GitHub .
Topics: Databases, Factual; Diagnosis, Computer-Assisted; Female; Fuzzy Logic; Humans; Neural Networks, Computer; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 34267261
DOI: 10.1038/s41598-021-93783-8 -
BMC Health Services Research Oct 2021Cervical cancer is the thirdly vast usual cause of cancer in women, and the second vast majority cause of death among women aged 14 to 44 years, both in developed and...
BACKGROUND
Cervical cancer is the thirdly vast usual cause of cancer in women, and the second vast majority cause of death among women aged 14 to 44 years, both in developed and developing countries. This paper aims to explore the perception of women and Health Care Workers (HCWs) about health care related factors affecting the Pap smear services among women who are screened in the Women Wellness Centre (WWC) in Suva, Fiji.
METHODS
This study used a qualitative method in July-September 2019 in which women screened for cervical cancer used in-depth interviews whereas HCWs used Focus Group Discussion (FGD) in WWC in Suva, Fiji. This study used purposive maximum variation sampling where participants are selected according to the inclusion and exclusion criteria. Semi-structured open ended questionnaires were used to collect the data among participants. Data coding was done until theoretical saturation was reached. Thematic analysis was used and all the text has been coded, themes were abstracted from the coded text segments.
RESULTS
A total of 20 women screened for cervical cancer and 5 HCWs were present during the duration of the study. Health care system was a factor recognized by both groups to have been a cause for the hindrance of cervical screening. There were 8 themes identified from the study, 3 themes from the women screened for cervical cancer and 5 from HCWs. Nearly all the participants reported about the compromised of cervical cancer screening services delivery because of factors such as lack of equipment and supplies, shortage of staff, long distances to health facilities, turnaround time and delay of results which affect the uptake of cervical cancer screening services.
CONCLUSION
While improvement has been made in the distribution of cervical cancer screening in WWC, a number of barriers and factors affect service uptake and delivery. Investments to be made in order to address the identified barriers such as turnaround time, long distances to health facilities, shortage of supplies and staff in order to improve uptake of cervical cancer screening services.
Topics: Early Detection of Cancer; Female; Fiji; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 34696802
DOI: 10.1186/s12913-021-07176-8 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2021The aim: The aim of this study was to determine the awareness level regarding pap smear in women living in Baghdad city, Iraq.
OBJECTIVE
The aim: The aim of this study was to determine the awareness level regarding pap smear in women living in Baghdad city, Iraq.
PATIENTS AND METHODS
Materials and methods: A cross-sectional study was done in 265 women living in Baghdad city using internet-based survey. Questionnaire was adopted from a previous study to measure the awareness level among women.
RESULTS
Results: the results showed that only 8(3%) of the respondent had a family history of cervical cancer. Almost (94%) have heard about cervical cancer, while only (38%) knew that HPV virus is the cause of cervical cancer. Majority of the respondents (87%) heard about pap smear while only 67 (25.0 %) had performed pap smear before. A total of 86% agreed that early diagnosis is important in treating of the cervical cancer.
CONCLUSION
Conclusions: Majority of women heard of cervical cancer and pap smear, but the level of its practice is still low with only 25% of respondents had performed it before. More health promotion is needed especially, at the primary care level regarding the importance of performing regular pap smear especially for women with family history of the cervical cancer.
Topics: Cross-Sectional Studies; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Iraq; Mass Screening; Papanicolaou Test; Surveys and Questionnaires; Uterine Cervical Neoplasms
PubMed: 34824173
DOI: No ID Found -
European Journal of Cancer Prevention :... Sep 2019In Gulf Cooperation Council States, there is limited information on national levels of mammography and Pap smear screening uptake. The aim of this study is to provide a...
In Gulf Cooperation Council States, there is limited information on national levels of mammography and Pap smear screening uptake. The aim of this study is to provide a baseline for national estimates for mammography and Pap smear screening and to explore associations between screening uptake and socioeconomic factors. The nationally representative World Health Survey Plus, implemented in 2008/2009 in Kuwait, Oman, Saudi Arabia and United Arab Emirates (UAE), was used. Uptake of mammography and Pap smear was estimated for each country, followed by the examination of associations between screening and a range of socioeconomic variables. Levels of breast and cervical cancer screening uptake within recommended intervals in all countries were low. The percentages of women aged 40-75 years who had a mammogram were 4.9% in Saudi Arabia, 8.9% in Oman, 13.9% in the UAE and 14.6% in Kuwait. The percentages of women aged 25-49 years who had a Pap smear test were 7.6% in Saudi Arabia, 10.6% in Oman, 17.7% in Kuwait and 28.0% in the UAE. Marital status, wealth, education, nationality and place of residence are associated with screening uptake, with the lower educated, poor and unmarried having the lowest percentages of uptake. The four Gulf Cooperation Council countries need to set clear targets and increase the proportion of women who have regular breast and cervical cancer screening examinations. Health education campaigns and awareness programmes that are fully integrated into the health system are required to ensure women use services that are available to prevent breast and cervical cancers.
Topics: Adult; Age Factors; Aged; Breast; Breast Neoplasms; Cervix Uteri; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Incidence; Kuwait; Mammography; Mass Screening; Middle Aged; Oman; Papanicolaou Test; Patient Acceptance of Health Care; Patient Education as Topic; Saudi Arabia; Socioeconomic Factors; United Arab Emirates; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 30260812
DOI: 10.1097/CEJ.0000000000000466