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International Journal of Gynecological... Dec 2022Ovarian cancer is known for its poor prognosis, which is mainly due to the lack of early symptoms and adequate screening options. In this study we evaluated whether...
OBJECTIVE
Ovarian cancer is known for its poor prognosis, which is mainly due to the lack of early symptoms and adequate screening options. In this study we evaluated whether mutational analysis in cervicovaginal and endometrial samples could assist in the detection of ovarian cancer.
METHODS
In this prospective multicenter study, we included patients surgically treated for either (suspicion of) ovarian cancer or for a benign gynecological condition (control group). A cervicovaginal self-sample, a Papanicolaou (Pap) smear, a pipelle endometrial biopsy, and the surgical specimen were analyzed for (potentially) pathogenic variants in eight genes (, , , , , , , and ) using single-molecule molecular inversion probes. Sensitivity and specificity were calculated to assess diagnostic accuracy.
RESULTS
Based on surgical histology, our dataset comprised 29 patients with ovarian cancer and 32 controls. In 83% of the patients with ovarian cancer, somatic (potentially) pathogenic variants could be detected in the final surgical specimen, of which 71% included at least a variant. In 52% of the ovarian cancer patients, such variants could be detected in either the self-sample, Pap smear, or pipelle. The Pap smear yielded the highest diagnostic accuracy with 26% sensitivity (95% CI 10% to 48%). Overall diagnostic accuracy was low and was not improved when including variants only.
CONCLUSIONS
Mutational analysis in cervicovaginal and endometrial samples has limited accuracy in the detection of ovarian cancer. Future research with cytologic samples analyzed on methylation status or the vaginal microbiome may be relevant.
Topics: Humans; Female; Prospective Studies; Ovarian Neoplasms; Papanicolaou Test; Endometrium; Vagina; Endometrial Neoplasms
PubMed: 36384753
DOI: 10.1136/ijgc-2022-003911 -
BMC Public Health Oct 2023Breast cancer and cervical cancer are among the most common cancers in women in Germany. Early detection examinations such as mammography and the cervical smear test...
BACKGROUND
Breast cancer and cervical cancer are among the most common cancers in women in Germany. Early detection examinations such as mammography and the cervical smear test (Pap-test) have been shown to contribute to the reduction in the mortality and/or incidence of these cancers and can be utilised free of charge by women in certain age groups as part of national screening programmes. Analyses show that the use of health services varies regionally, especially when comparing the federal states of the former German Democratic Republic (GDR, Eastern Germany) and the Federal Republic of Germany (FRG, Western Germany). This study investigated to what extent the utilisation of mammography examinations and Pap-tests by women differs in federal states of former GDR and FRG.
METHODS
For this purpose, we analysed data from the nationwide health survey GEDA14/15 conducted by the Robert Koch Institute (RKI) in 2014 and 2015. We calculated weighted proportions and compared attendance between eastern and western German states by a Chi-Square-test. Additionally, we conducted regression analysis to adjust for socio-economic status, living environment and place of birth.
RESULTS
2,772 female participants aged 20-34 years were analysed for Pap-test attendance in the last two years and 4,323 female participants aged 50-69 years old were analysed for mammography screening attendance in the last two years. 50-69-year-old women in eastern German states were with 78.3% (95%-CI 75.3%, 81.2%) more likely to attend mammography screening than in western Germany with 73.4% (95%-CI 71.8%, 74.9%). Pap-test uptake was statistically significantly higher in the East of Germany with 83.3% (95%-CI 79.6%, 87.1%) compared to 77.5% (95%-CI 75.8%, 79.3%) in the West of Germany. This relationship was robust to adjusting for socio-economic status, living environment and place of birth.
CONCLUSIONS
Cultural influences and socialization in the GDR might explain the higher utilisation of these cancer screening examinations at least to some extent. This could have many reasons, for example a higher health awareness through education or a possible greater trust in medical structures and the associated higher compliance of women. These hypotheses should be further explored to increase the uptake of screening examinations by women in Germany.
Topics: Female; Humans; Middle Aged; Aged; Child, Preschool; Uterine Cervical Neoplasms; Germany, East; Early Detection of Cancer; Breast Neoplasms; Mammography; Health Surveys; Papanicolaou Test; Germany; Mass Screening; Vaginal Smears
PubMed: 37798695
DOI: 10.1186/s12889-023-16849-4 -
The Pan African Medical Journal 2022the prevalence of cervical squamous intraepithelial lesion is not well appreciated in most low-income countries. The study aimed to determine the level of awareness,...
INTRODUCTION
the prevalence of cervical squamous intraepithelial lesion is not well appreciated in most low-income countries. The study aimed to determine the level of awareness, prevalence and the pattern of squamous intraepithelial lesions and predictors for abnormal Pap smear reports (development of pre-malignant lesions of the cervix) among women attending various clinics in a tertiary health facility in Enugu, Nigeria.
METHODS
a cross-sectional study of 207 female patients attending various clinics of Enugu State University Teaching Hospital, Parklane, Enugu between June and August 2017 was undertaken. Structured interviewer-administered questionnaires were used for data collection while cervical smears were collected from the patients and sent for cytology. Data analysis was done using the Statistical Package for the Social Sciences (SPSS) version 22.0. The results were presented as means, standard deviations, frequencies and proportions. Pearson´s Chi-square test was used to test for associations between categorical variables and statistical significance was set at a p-value of < 0.05.
RESULTS
the levels of awareness of cervical cancer and the screening methods among the respondents were 76.8% and 36.7% respectively. The overall knowledge of cervical cancer and its screening was poor (6.8% and 29.0% respectively). The prevalence of pre-malignant lesions of the cervix among the respondents was 15.0% with low grade squamous intraepithelial lesion (LGSIL) having the highest frequency (38.7%). Among all the other risk factors for the development of premalignant lesions of the cervix among the respondents, a report of abnormal pap (positive) smear report was significantly associated with only age ≥35 years (χ=5.723; p=0.017). The same age of 35 years and above also correctly predicted abnormal Pap smear reports among other factors (AOR = 3.02, 95% CI = 1.16 - 7.89, p = 0.024).
CONCLUSION
the awareness of cervical cancer and cervical cancer screening was high but the overall knowledge on cervical cancer and its screening was very poor among the respondents. The prevalence of pre-malignant lesions of the cervix was high, and the commonest abnormal smear was LGSIL. Only age 35 years and above correctly predicted the occurrence of abnormal Pap smear reports among the respondents.
Topics: Adult; Cross-Sectional Studies; Early Detection of Cancer; Female; Humans; Male; Nigeria; Papanicolaou Test; Squamous Intraepithelial Lesions; Uterine Cervical Neoplasms; Uterine Cervical Dysplasia
PubMed: 35480408
DOI: 10.11604/pamj.2022.41.130.28173 -
Asian Pacific Journal of Cancer... 2016Despite the established role of the Pap smear test (PST) in prevention and early detection of cervical cancer, it is still rarely practiced in Sudan. Many challenges...
BACKGROUND
Despite the established role of the Pap smear test (PST) in prevention and early detection of cervical cancer, it is still rarely practiced in Sudan. Many challenges hinder the establishment of an effective cervical cancer screening program, including socio-cultural factors. Therefore, this study aimed to investigate the knowledge, attitudes and practices (KAP) of Sudanese women with regard to the Pap smear test and cervical cancer.
MATERIALS AND METHODS
A total of 500 married women aged 14 to 58 years were recruited from obstetric clinics, hospitals and universities in Khartoum in 2014. Data were collected using a standardized, pretested questionnaire that inquired socio-demographic characteristics and their KAP about cervical cancer and the PST.
RESULTS
More than 52% of participating women were above 30 years of age, and the majority (78.8%) were university degree holders. A total of 486 (97.2 %) of participants were resident in urban areas of Khartoum State. However about 48% of the respondents had never heard about PST, and only 15.8% of the participants had undergone a Pap smear test previously; 46.6% (233/500) knew that the human papilloma virus (HPV) was the causative agent, but only 39.2% (196/500) had heard about HPV vaccination, and only 11.4% (57/500) had received the vaccine. However 68% of the respondents agreed to do Pap smear if properly informed about the test and 75.4% of the respondents agreed to participate in a cervical cancer screening program.
CONCLUSIONS
Despite a high educational level, less than half of our participants had accurate knowledge about cervical cancer, HPV, and cervical cancer screening. Health education about cervical cancer, HPV and sexually transmitted infections and the role of PST in cervical cancer prevention are crucial when designing interventions aimed at improving cervical cancer screening for Sudanese women.
Topics: Adolescent; Adult; Cross-Sectional Studies; Early Detection of Cancer; Female; Follow-Up Studies; Health Education; Health Knowledge, Attitudes, Practice; Humans; Middle Aged; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Papillomavirus Vaccines; Prognosis; Sudan; Uterine Cervical Neoplasms; Vaccination; Vaginal Smears; Young Adult
PubMed: 26925654
DOI: 10.7314/apjcp.2016.17.2.625 -
Scientific Reports Feb 2023The newest high-risk human papillomavirus (HPV) detection techniques were included for cervical cancer primary screening under the Spanish National Health System in...
The newest high-risk human papillomavirus (HPV) detection techniques were included for cervical cancer primary screening under the Spanish National Health System in 2019. These analyses allow changing population approaches to foster adherence to screening. Therefore, the validity of self versus conventional sampling for HPV and cytology analyses was appraised. Women's preferences concerning samples and devices were also evaluated. This is a diagnostic accuracy cross-sectional study among 120 women recruited from a colposcopy clinic at a general hospital in Illes Balears, Spain. Participants were given written information and asked for a self-sample. One of two sets containing two devices each were handed. One set was transported dry and the second in liquid medium. Next, clinicians collected vaginal samples that were our gold standards. The agreement between both techniques was examined with the Kappa coefficient (κ). Self-sampling evaluation and preferences for different vaginal devices were also surveyed. The agreement between self and conventional samples concerning HPV positivity was very good (κ 0.86 for Mía by XytoTest® and 0.83 for Viba-Brush®) or reasonable (κ 0.73 for Iune and 0.68 for viscose swab). Pap smears from self-samples exhibited moderate agreement (κ 0.41 for Mía® and 0.51 for Viba-Brush® respectively) for negative versus ASC-US and worse results. Most of the participants considered self-sampling as beneficial (110 or 91.7%) and the advantages were, in decreasing order, scheduling, comfort, intimacy and less fear for pain or disturbance. The priority of choice for the devices was Mía® and viscose swab (chosen in first or second place) in opposition to Iune and Viba-Brush® (chosen in third or fourth place). If Viba-Brush® was to collect the best quality samples, 108 women (94.7%) switched their decisions. Our agreement between self and conventional samples was very good or reasonable for HPV, with the best values for devices in a liquid medium, and moderate for cytology. Even so, reflex cytology on self-samples is a valuable tool in promoting adherence. Self-sampling was widely accepted for smooth and thin devices. However, there is no resistance to change to others if a higher quality of the sample is obtained.
Topics: Female; Humans; Cross-Sectional Studies; Early Detection of Cancer; Human Papillomavirus Viruses; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Specimen Handling; Uterine Cervical Neoplasms; Vaginal Smears; Self-Testing
PubMed: 36797261
DOI: 10.1038/s41598-023-29255-y -
Asian Pacific Journal of Cancer... Jun 2022This survey examined the barriers to cervical cancer screening uptake by adult women in Nnewi, a town located in southeast Nigeria.
OBJECTIVE
This survey examined the barriers to cervical cancer screening uptake by adult women in Nnewi, a town located in southeast Nigeria.
METHODS
In this descriptive survey, data were collected data from 379women aged between 21 and 65 years using the adapted version of the Health Belief Model Scale for Cervical Cancer and Pap smear test questionnaire.
RESULTS
The major perceived barriers to the practice of cervical cancer screening were fear of the result (2.32±1.05), lack of knowledge of what pap smear is (2.32±0.90), and lack of information about when and where pap smear could be done (2.25±1.07). The logistic regression model showed that the following perceived barriers predicted uptake of cervical cancer screening (P< 0.05): time constraint (P = 0.001, OR= 3.368, CI= 1.455, 4.11); attitude of healthcare workers (P = 0.008, OR= 6.642; CI= 2.764, 18.196); knowledge of test frequency (P = 0.005, OR= 1.443; CI 0.946, 3.811); fear of result(P = 0.001, OR= 3.660, CI=0.679, 4.061); lack of information on when and where pap smear could be obtained (P = 0.010; OR= 6.732; CI= 2.286, 10.490); distance from test centre (P = 0.003; OR= 1.387; CI=0.126, 2.193); not knowing what it is for (P = 0.024, OR10.895, CI = 2.938, 14.401).
Topics: Adult; Aged; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Middle Aged; Nigeria; Papanicolaou Test; Uterine Cervical Neoplasms; Young Adult
PubMed: 35763637
DOI: 10.31557/APJCP.2022.23.6.1959 -
BMC Women's Health Jun 2022Despite the early diagnosis and treatment of cervical cancer, it is still a significant public health problem in Somalia. This study was conducted to evaluate the...
Knowledge and attitudes of healthcare professionals working in a training and research hospital on early diagnosis of cervical cancer (a Somalia example): cross-sectional study.
BACKGROUND
Despite the early diagnosis and treatment of cervical cancer, it is still a significant public health problem in Somalia. This study was conducted to evaluate the knowledge and attitudes of healthcare professionals towards the early diagnosis of cervical cancer.
METHODS
This study was conducted in Mogadishu, the capital of Somalia, between December 2020 and February 2021. The cross-sectional study consisted of a total of 280 healthcare professionals. The study data was collected using a questionnaire consisting of 38 questions evaluating the knowledge and attitudes of all healthcare professionals towards the early diagnosis of cervical cancer, an additional 15 questions for women only, and a total of 43 questions.
RESULTS
22.1% of the participants received cervical cancer training during vocational education and training. Cervical cancer education after graduation is 16.8%, and the rate of providing education to patients is only 29.6%. The rate of female healthcare professionals having a Pap smear test is 2%. The participants' cervical cancer total knowledge score was 16.5 ± 6.69, and the success rate was 63.46. The highest success rate in knowledge subgroup questions was HPV questions with 69.6. A statistically significant difference was found between the participants' profession, training on the subject during their vocational education, and total knowledge scores (p < 0.001). When the knowledge question subscales were compared, a significant difference was found between participants' gender and HPV questions subscale score (p = 0.028). A statistically significant difference was found between the participants' professions, receiving training on the subject during vocational training, and all subscales (p < 0.05). A statistically significant difference was found between the participants' income status and risk factors questions scores (p = 0.026).
CONCLUSION
This study shows that the knowledge and training of healthcare professionals working in a training and research hospital in Somalia for early cervical cancer diagnosis are not sufficient. In addition, it reveals that female healthcare professionals have almost no Pap smears. Therefore, studies and training should be planned to train all healthcare professionals, especially female healthcare professionals, and overcome all possible obstacles to the acceptance of the screening tests by women.
Topics: Cross-Sectional Studies; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Hospitals; Humans; Papanicolaou Test; Papillomavirus Infections; Somalia; Surveys and Questionnaires; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35698067
DOI: 10.1186/s12905-022-01808-9 -
Asian Pacific Journal of Cancer... 2016The overall cervical cancer incidence rate is low in Iran; however, because of a higher risk of death for cervical cancer, a disease that kills women in middle age, a...
BACKGROUND
The overall cervical cancer incidence rate is low in Iran; however, because of a higher risk of death for cervical cancer, a disease that kills women in middle age, a cervical cancer control program is needed. The aim of this study was to provide consensus recommendation for cervical cancer prevention in Iran and other Muslim societies with low incidences of cervical cancer.
MATERIALS AND METHODS
Through a practical guideline development cycle, we developed six questions that were relevant to produce the recommendation. We reviewed 190 full text records of cervical cancer in Iran (1971 to 2013) of which 13 articles were related to the data needed to answer the recommendation questions. We also reviewed World Health Organization, IARC, GLOBOCAN report, Iran Ministry of Health cancer registry report and 8 available foreign countries guidelines. Lastly, we also evaluated the Pap smear results of 825 women who participated in the Iranian HPV survey, of whom 328 were followed-up after a 5-year interval.
RESULTS
The obtained data highlighted the burden of HPV and cervical cancer situation in Iran. Experts emphasized the necessity of a cervical cancer screening program for Iranian women, and recommended an organized screening program with a cytological evaluation (Pap smear) that would start at the age of 30 years, repeated every 5 years, and end at the age of 69 years. Meanwhile, there is no need for screening among women with a hysterectomy, and screening should be postponed to post-partum among pregnant women.
CONCLUSIONS
An organized cervical cancer screening is a necessity for Iran as more than 500-900 women in middle age diagnosed with an invasive cervical cancer every year cannot be ignored. This recommendation should be taken into account by the National Health System of Iran and Muslim countries with shared culture and behavior patterns. CUBA HPV test could be consideration in countries Muslim country with appropriate budget, resources and facility.
Topics: Adolescent; Adult; Early Detection of Cancer; Female; Humans; Hysterectomy; Incidence; Iran; Islam; Mass Screening; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult
PubMed: 26838217
DOI: 10.7314/apjcp.2016.17.1.239 -
PloS One 2017p16 immunohistochemistry is used to evaluate for HPV-associated cervical intraepithelial neoplasia. The diagnostic performance of p16 in HIV infection is unclear. (Clinical Trial)
Clinical Trial
BACKGROUND
p16 immunohistochemistry is used to evaluate for HPV-associated cervical intraepithelial neoplasia. The diagnostic performance of p16 in HIV infection is unclear.
METHODS
Between June-December 2009, HIV-infected women underwent Papanicolaou (Pap) smear, human papillomavirus (HPV) testing, visual inspection with acetic acid (VIA), and colposcopy-directed biopsy as the disease gold standard at a HIV clinic in Kenya. Pap smears were evaluated for p16 expression. Sensitivity, specificity, positive predictive value (PPV), and area under the receiver operating characteristic curve (AUC) of p16 to detect CIN2/3 on histology and the impact of immunosuppression and ART was assessed.
RESULTS
Of 331 cervical samples with p16 expression, p16 sensitivity and specificity to detect CIN2/3 was 54.1% and 72.4% respectively, which was lower than Pap and HPV in sensitivity, but higher in specificity than Pap, HPV, and VIA. Combining tests and p16 reduced sensitivity and increased specificity of Pap from 90.5% to 48.7% and 51.4% to 81.7%; of VIA from 59.5% to 37.8% and 67.6% to 89.9%; and of HPV from 82.4% to 50.0% and 55.3% to 84.8%. Combination p16 increased the PPV of Pap from 34.9% to 43.4%; of HPV from 34.7% to 48.7%; and VIA from 34.9% to 51.9%. Adjunctive p16 did not change AUC (P>0.05). P16 performance was not altered by immunosuppression or ART use. Combining p16 with HPV and VIA reduced the variation in HPV and VIA performance associated with CD4 and ART.
CONCLUSION
As an adjunctive test in HIV-infected women, p16 immunohistochemistry increased specificity and PPV of HPV and VIA for CIN2/3, and was not altered in performance by immunosuppression, ART, or age.
Topics: Adolescent; Adult; Female; HIV Infections; HIV Protease; HIV-1; Humans; Immunohistochemistry; Kenya; Mass Screening; Middle Aged; Papanicolaou Test; Uterine Cervical Neoplasms
PubMed: 29023464
DOI: 10.1371/journal.pone.0185597 -
Asian Pacific Journal of Cancer... Mar 2020We examined the effectiveness of a health education program to improve; knowledge and attitude towards cervical cancer and Pap smear, and uptake of Pap smear test among... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
We examined the effectiveness of a health education program to improve; knowledge and attitude towards cervical cancer and Pap smear, and uptake of Pap smear test among female entrepreneurs in Kedah, a northern state of Malaysia.
METHODS
This controlled community trial involved 210 women from the districts of Alor Setar and Sungai Petani. Simple random sampling was applied to select 105 women from each district. Self-administered questionnaires were used to obtain information about the variables of interest. Health education intervention program included educational talk, demo video, experience sharing, pamphlet distribution, and text message reminders. Evaluation of outcomes was performed twice. The text message reminders acted as the cues to action that were sent between the two evaluation times at one-month interval. Women in the control group received educational talk alone. In the control group, evaluation of outcomes was done only once, which was one month after the educational talk.
RESULTS
Knowledge on cervical cancer and Pap smear, and attitude towards Pap smear among women in both intervention and control group improved significantly at Evaluation stage 1. However, no further improvements were observed in the intervention group at Evaluation stage 2. The uptake of Pap smear in the intervention group increased significantly from 48.0% at Baseline to 68.0% at Evaluation stage 1 (P<0.001), and from 68.0% to 79.0% at Evaluation stage 2 (P<0.001). A significant increase in Pap smear uptake was also seen in the control group from 63.0% at Baseline to 76.0% at Evaluation stage 1 (P=0.003).
CONCLUSIONS
Educational talk alone was effective in improving knowledge on cervical cancer and Pap smear, attitude towards the test, and the actual uptake of the test. However, text reminders were more effective than having an educational talk alone in increasing uptake of Pap smear test among participants.
.Topics: Adult; Aged; Attitude to Health; Female; Health Education; Health Promotion; Humans; Malaysia; Middle Aged; Papanicolaou Test; Uterine Cervical Neoplasms; Young Adult
PubMed: 32212817
DOI: 10.31557/APJCP.2020.21.3.853