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Cervical Cancer Prevention, Its Challenges and Solutions in Iran and Worldwide: A Systematic Review.Iranian Journal of Public Health Nov 2023Widespread use of screening in high-income countries has led to significant reductions in mortality from cervical cancer. However, in Iran, the main reason for the late... (Review)
Review
BACKGROUND
Widespread use of screening in high-income countries has led to significant reductions in mortality from cervical cancer. However, in Iran, the main reason for the late diagnosis of cervical cancer was the failure to perform a Pap smear (Papanicolaou). We aimed to investigate the status of cervical cancer prevention and its challenges and solutions in Iran.
METHOD
We conducted a systematic review of literature published from 1974 to 2021 in the electronic databases, including PubMed, Web of Science, Embase, Scopus, and Google Scholar, and retrieved all English-language articles. Following the application of the inclusion and exclusion criteria, full-text articles were identified and evaluated for eligibility. Finally, these publications were analyzed as part of the synthesis.
RESULTS
Lower social-economic level, inadequate knowledge of screening tests and health centers for Pap test performance leading to worse outcomes such as lower screening participation or coverage.
CONCLUSION
By addressing these challenges through increasing education, increasing service accessibility, expanding screening programs, improving public awareness, improving insurance coverage, and establishing a control protocol for follow-up, it is possible to reduce cervical cancer incidence and mortality.
PubMed: 38106838
DOI: 10.18502/ijph.v52i11.14031 -
Health Care For Women International 2024We performed a systematic review and meta-analysis to evaluate the accuracy of screening cervical cancer tests as alternative standalone methods. The combined estimates... (Meta-Analysis)
Meta-Analysis
We performed a systematic review and meta-analysis to evaluate the accuracy of screening cervical cancer tests as alternative standalone methods. The combined estimates of sensitivity of visual inspection with acetic acid, visual inspection with lugol's iodine, conventional pap smear, liquid-based cytology, High risk HPV testing by clinician, High risk HPV testing by self- sampling, cervicography were 64%, 80%, 55%, 70%, 70% and 67% respectively; the combine values of specificity of these screening strategies were 88%, 88%, 96%, 59%, 94%, and 95% respectively. Our findings draw attention to an attractive opinion to facilitate the collection of specimens for DNA HPV by patients in settings where they don't have access to a regular screening programs.
Topics: Female; Humans; Uterine Cervical Neoplasms; Uterine Cervical Dysplasia; Vaginal Smears; Early Detection of Cancer; Papillomavirus Infections; Mass Screening; Sensitivity and Specificity
PubMed: 35084291
DOI: 10.1080/07399332.2021.1998059 -
Archives of Gynecology and Obstetrics Mar 2024This systematic review aims to provide a data synthesis about the risk of neovaginal cancer in women with Müllerian anomalies and to investigate the association between... (Review)
Review
PURPOSE
This systematic review aims to provide a data synthesis about the risk of neovaginal cancer in women with Müllerian anomalies and to investigate the association between the adopted reconstructive technique and the cancer histotype.
METHODS
PubMed, MEDLINE, Embase, Scopus, ClinicalTrials.gov and Web of Science databases were searched from inception to March 1st, 2023. Studies were included if: (1) only women affected by Müllerian malformations were included, (2) the congenital defect and the vaginoplasty technique were clearly reported, (3) the type of malignancy was specified.
RESULTS
Literature search yielded 18 cases of squamous cell carcinoma and two cases of vaginal intraepithelial neoplasia 3 (VAIN 3). Of these, 3 had been operated on according to the Wharton technique, 8 according to the McIndoe technique, 3 with a split-skin graft vaginoplasty, 2 according to the Davydov technique, 2 with a simple cleavage technique, 1 according to the Vecchietti technique and 1 with a bladder flap vaginoplasty. A total of 17 cases of adenocarcinoma and 1 case of high-grade polypoid dysplasia were also described. Of these, 15 had undergone intestinal vaginoplasty, 1 had been operated on according to the McIndoe technique and 1 had undergone non-surgical vaginoplasty. Finally, 1 case of verrucous carcinoma in a woman who had undergone a split-skin graft vaginoplasty, was reported.
CONCLUSION
Although rare, neovaginal carcinoma is a definite risk after vaginal reconstruction, regardless of the adopted technique. Gynaecologic visits including the speculum examination, the HPV DNA and/or the Pap smear tests should be scheduled on an annual basis.
Topics: Humans; Female; Vagina; Plastic Surgery Procedures; Vaginal Neoplasms; Carcinoma, Squamous Cell; Adenocarcinoma; Mullerian Ducts; 46, XX Disorders of Sex Development; Congenital Abnormalities; Gynecologic Surgical Procedures; Treatment Outcome
PubMed: 37466686
DOI: 10.1007/s00404-023-07086-6