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Journal of Cancer Policy Dec 2023Eastern Europe and Central Asia (EECA) countries have higher cervical and breast cancer mortality rates and later stage at diagnosis compared with the rest of WHO...
BACKGROUND
Eastern Europe and Central Asia (EECA) countries have higher cervical and breast cancer mortality rates and later stage at diagnosis compared with the rest of WHO European Region. The aim was to explore current early detection practices including "dispensarization" for breast and cervix cancer in the region.
METHODS
A questionnaire survey on early detection practices for breast and cervix cancer was sent to collaborators in 11 countries, differentiating services in the primary health setting, and population-based programs. Responses were received from Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Russian Federation (Arkhangelsk, Samara and Tomsk regions), Tajikistan, Ukraine, and Uzbekistan.
RESULTS
All countries but Georgia, Kyrgyzstan, and the Russian Federation had opportunistic screening by clinical breast exam within "dispensarization" program. Mammography screening programs, commonly starting from age 40, were introduced or piloted in eight of nine countries, organized at national oncology or screening centres in Armenia, Belarus and Georgia, and within primary care in others. Six countries had "dispensarization" program for cervix cancer, mostly starting from the age 18, with smears stained either by Romanowsky-Giemsa alone (Belarus, Tajikistan and Ukraine), or alternating with Papanicolaou (Kazakhstan and the Russian Federation). In parallel, screening programs using Papanicolaou or HPV test were introduced in seven countries and organized within primary care.
CONCLUSION
Our study documents that parallel screening systems for both breast and cervix cancers, as well as departures from evidence-based practices are widespread across the EECA. Within the framework of the WHO Initiatives, existing opportunistic screening should be replaced by population-based programs that include quality assurance and control.
Topics: Female; Humans; Adult; Adolescent; Uterine Cervical Neoplasms; Early Detection of Cancer; Europe, Eastern; Asia, Central; Russia
PubMed: 37544479
DOI: 10.1016/j.jcpo.2023.100436 -
Factors related to knowledge, attitudes, and behaviors regarding cervical cancer among Yemeni women.BMC Cancer Jun 2024Cervical cancer (CxCa), although preventable, is still among the most prevalent cancers in women. Mortality from this cancer is high, especially in low-income countries...
BACKGROUND
Cervical cancer (CxCa), although preventable, is still among the most prevalent cancers in women. Mortality from this cancer is high, especially in low-income countries where preventive strategies are often lacking. We studied the knowledge, attitudes, and practices regarding CxCa among Yemeni women.
METHODS
This cross-sectional study was conducted in 2019 among 399 women in five major hospitals in Sanaa, the capital city of Yemen. Data were collected through face-to-face interviews using structured questionnaires. We used logistic regression models to analyze the likelihood of hearing about CxCa, believing that CxCa is treatable and preventable, awareness of the Pap smear test, and ever having this test, in relation to participant's age, education level, working outside the household, and family history of CxCa.
RESULTS
Only 66.7% of the women had heard of CxCa. Women with higher education, working outside the household, and with a family history of CxCa were more likely to be aware of CxCa. Working outside the household was the only variable related to a higher likelihood of knowing that CxCa is a treatable and preventable. Furthermore, women with a family history of CxCa were more likely to have knowledge about Pap smear test and were more likely to have Pap smear test in the past.
CONCLUSION
This study identified a low awareness of CxCa and its prevention among Yemeni women. In order to reduce the burden of CxCa in Yemen and save women's lives, it is necessary to raise women's awareness of this disease, especially among those with lower education and those not involved in work outside their homes.
Topics: Humans; Female; Uterine Cervical Neoplasms; Health Knowledge, Attitudes, Practice; Yemen; Cross-Sectional Studies; Adult; Middle Aged; Papanicolaou Test; Young Adult; Surveys and Questionnaires; Vaginal Smears; Aged
PubMed: 38844917
DOI: 10.1186/s12885-024-12435-y -
BMC Pregnancy and Childbirth Oct 2023Preconception care (PCC) is the term used for activities and interventions designed to address and prevent problems related to pregnancy, the neonatal period and...
BACKGROUND
Preconception care (PCC) is the term used for activities and interventions designed to address and prevent problems related to pregnancy, the neonatal period and childhood. This study assessed maternal health status prior to conception in Trinidad by means of a screening tool, physical measurements, and laboratory samples.
METHODS
A cross-sectional study was conducted among women aged 18-45 years at a primary care centre in Arima, Trinidad. A de novo PCC screening tool was used to assess 13 domains of high-risk pregnancy in participants. These domains included dietary details, gynaecological and obstetric histories, and genetic and vaccination histories, among others. Blood pressure, weight, height, and waist circumference were recorded, and a capillary blood sample was used to determine random blood glucose and HbA1c levels. All data were coded and entered into SPSS ver. 21.
RESULTS
A total of 400 nongravid participants were recruited, of whom 366 were included in the final analysis. Most (96.7%) had one or more risk factors for adverse pregnancy outcomes. These included overweight (27%), obesity (35%), central obesity (69.4%), and impaired glucose tolerance/diabetes mellitus (IGT/DM) (26.2%). Additionally, a sedentary lifestyle and diet high in processed food/fats were self-reported by 74.9% and 88.8% of participants, respectively. Only 13.1% had planned to conceive, and of those who had no immediate plans to conceive, 76.4% were currently sexually active, and many (60.7%) did not use birth control techniques. More than half (57.1%) had never had a pap smear. On the other hand, 86.3% knew their HIV status. Self-reported percentages for vaccination were as follows: MMR (100%), tetanus (17.5%), hepatitis B (11.5%) and influenza (2.7%). The majority (82.8%) of participants had not visited the dentist in the past year, with 35.9% of these individuals reporting symptoms of periodontitis. Segments of the population had multiple risk factors; for example, 23.7% of participants were overweight or obese and had an elevated HbA1c level.
CONCLUSIONS
Unexpectedly, most participants had a risk factor for an adverse pregnancy outcome, and many had multiple risk factors. There is a strong case for enhanced preconception care for women in Trinidad.
Topics: Adult; Middle Aged; Young Adult; Cross-Sectional Studies; Glycated Hemoglobin; Obesity; Overweight; Preconception Care; Trinidad and Tobago; Humans; Female
PubMed: 37817065
DOI: 10.1186/s12884-023-06017-2 -
Scientific Reports May 2024Cervical cancer, the second most prevalent cancer affecting women, arises from abnormal cell growth in the cervix, a crucial anatomical structure within the uterus. The...
Cervical cancer, the second most prevalent cancer affecting women, arises from abnormal cell growth in the cervix, a crucial anatomical structure within the uterus. The significance of early detection cannot be overstated, prompting the use of various screening methods such as Pap smears, colposcopy, and Human Papillomavirus (HPV) testing to identify potential risks and initiate timely intervention. These screening procedures encompass visual inspections, Pap smears, colposcopies, biopsies, and HPV-DNA testing, each demanding the specialized knowledge and skills of experienced physicians and pathologists due to the inherently subjective nature of cancer diagnosis. In response to the imperative for efficient and intelligent screening, this article introduces a groundbreaking methodology that leverages pre-trained deep neural network models, including Alexnet, Resnet-101, Resnet-152, and InceptionV3, for feature extraction. The fine-tuning of these models is accompanied by the integration of diverse machine learning algorithms, with ResNet152 showcasing exceptional performance, achieving an impressive accuracy rate of 98.08%. It is noteworthy that the SIPaKMeD dataset, publicly accessible and utilized in this study, contributes to the transparency and reproducibility of our findings. The proposed hybrid methodology combines aspects of DL and ML for cervical cancer classification. Most intricate and complicated features from images can be extracted through DL. Further various ML algorithms can be implemented on extracted features. This innovative approach not only holds promise for significantly improving cervical cancer detection but also underscores the transformative potential of intelligent automation within the realm of medical diagnostics, paving the way for more accurate and timely interventions.
Topics: Humans; Uterine Cervical Neoplasms; Female; Deep Learning; Early Detection of Cancer; Neural Networks, Computer; Algorithms; Papanicolaou Test; Colposcopy
PubMed: 38734714
DOI: 10.1038/s41598-024-61063-w -
The Pan African Medical Journal 2024cervical cancer is a health concern worldwide. The South Kivu Province in the Eastern DR Congo is facing many cases of this disease but poorly screened and reported. The...
Cervical precancerous and cancerous lesions screening using Pap smear test at Provincial Referral Hospital of Bukavu, Eastern DR Congo: profile and recommendations to stakeholders.
INTRODUCTION
cervical cancer is a health concern worldwide. The South Kivu Province in the Eastern DR Congo is facing many cases of this disease but poorly screened and reported. The objective of this was to determine the prevalence of cell abnormalities at cervical cytology in a tertiary teaching hospital in Bukavu and their association with common risk factors of cervical cancer.
METHODS
a cross-sectional study was conducted on 142 women attending the Provincial Referral Hospital of Bukavu (HPGRB) from February to December 2021. Quantitative variables were described by their median following their asymmetric distributions and the qualitative variables in absolute and relative frequencies. Then the Chi-square test was used for the comparison of proportion.
RESULTS
forty-five percent of the participants had between three and five children. Twenty-two (15.5%) of the 142 patients reported to have two or more sexual partners and 17.5% reported the use of hormonal contraception. The prevalence of cell abnormalities at cervical cytology was 17% of which Low- Grade Squamous Intraepithelial Lesion (LSIL) was the most representative (12.9%). There was no statistically significant association between the common cervical risk factors and the occurrence of cell abnormalities.
CONCLUSION
cervical pre-cancerous lesions are frequent in South Kivu province. The Pap smear test remains an early and affordable screening method and constitutes a secondary prevention strategy in women of 18 years and older in a low-income country such as DR Congo where vaccination against HPV is still hypothetic.
Topics: Humans; Female; Cross-Sectional Studies; Uterine Cervical Neoplasms; Democratic Republic of the Congo; Adult; Papanicolaou Test; Middle Aged; Young Adult; Vaginal Smears; Prevalence; Early Detection of Cancer; Mass Screening; Risk Factors; Uterine Cervical Dysplasia; Precancerous Conditions; Squamous Intraepithelial Lesions of the Cervix; Adolescent; Aged
PubMed: 38646136
DOI: 10.11604/pamj.2024.47.57.39090 -
BMC Women's Health Jan 2024To assess knowledge, attitudes, and practices regarding cervical cancer and Pap smear screening among Omani women attending a tertiary clinic in Muscat, Oman, and to... (Observational Study)
Observational Study
OBJECTIVES
To assess knowledge, attitudes, and practices regarding cervical cancer and Pap smear screening among Omani women attending a tertiary clinic in Muscat, Oman, and to establish correlations with selected sociodemographic factors.
METHODS
An observational, cross-sectional study was carried out among Omani women aged 18-50 years old attending the outpatient clinic of the Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, from October 2019 to February 2020. A validated Arabic-language questionnaire was utilized to collect data regarding the participants' sociodemographic characteristics, their knowledge of cervical cancer and related risk factors, and their knowledge, attitudes, and practices related to cervical cancer screening and Pap smear testing.
RESULTS
Of the 380 respondents, 86 and 55% had previously heard of cervical cancer and Pap smear testing, respectively; however, only 26% were knowledgeable concerning these topics. Knowledge scores were significantly associated with various sociodemographic factors, including marital status and a previous awareness of cervical cancer (odds ratio: > 1, p < 0.05). Only 21% had themselves previously undergone Pap smear testing; however, 75% reported being willing to undergo such screening in future.
CONCLUSIONS
Knowledge regarding cervical cancer-related risk factors and Pap smear screening was poor among a cohort of Omani women attending a tertiary clinic in Muscat, Oman. This may play a role in the increased frequency of cervical cancer cases observed in Oman over recent years. As such, a well-structured public education program is recommended to raise awareness of this issue.
Topics: Female; Humans; Adolescent; Young Adult; Adult; Middle Aged; Vaginal Smears; Papanicolaou Test; Uterine Cervical Neoplasms; Cross-Sectional Studies; Early Detection of Cancer; Health Knowledge, Attitudes, Practice; Hospitals, Teaching; Surveys and Questionnaires; Mass Screening
PubMed: 38218830
DOI: 10.1186/s12905-023-02870-7 -
Revista Brasileira de Epidemiologia =... 2023To estimate prevalence, assess trends and identify factors associated with non-performance of Pap smears among postpartum women residing in Rio Grande, Southern Brazil.
OBJECTIVE
To estimate prevalence, assess trends and identify factors associated with non-performance of Pap smears among postpartum women residing in Rio Grande, Southern Brazil.
METHODS
Between 01/01 and 12/31 of 2007, 2010, 2013, 2016 and 2019, previously trained interviewers applied a single standardized questionnaire at the hospital to all postpartum women residing in this municipality. It was investigated from the planning of pregnancy to the immediate postpartum period. The outcome consisted of not performing a Pap smear in the last three years. The chi-square test was used to compare proportions and assess trends, and Poisson regression with robust variance adjustment in the multivariate analysis. The measure of effect was the prevalence ratio (PR).
RESULTS
Although 80% of the 12,415 study participants had performed at least six prenatal consultations, 43.0% (95%CI 42.1-43.9%) had not been screened in the period. This proportion ranged from 64.0% (62.1-65.8%) to 27.9% (26.1-29.6%). The adjusted analysis showed a higher PR for not performing Pap smears among younger puerperal women, living without a partner, with black skin color, lower schooling, and family income, who did not have paid work during pregnancy or planned pregnancy, who attended fewer prenatal consultations. smoked during pregnancy and were not being treated for any illness.
CONCLUSION
Despite the improvement in coverage, the observed rate of non-performance of Pap smears is still high. Women most likely to have cervical cancer were those who had the highest PR for not having this test.
Topics: Female; Humans; Pregnancy; Brazil; Cross-Sectional Studies; Income; Papanicolaou Test; Pregnant Women; Socioeconomic Factors; Uterine Cervical Neoplasms; Prevalence; Postpartum Period
PubMed: 37436328
DOI: 10.1590/1980-549720230032 -
Cancer Medicine Sep 2023Endometrial lesions are morphologically diverse and uncommon on cervical smears, with its detection rate and associated diagnostic categories uncharacterized. In this...
INTRODUCTION
Endometrial lesions are morphologically diverse and uncommon on cervical smears, with its detection rate and associated diagnostic categories uncharacterized. In this study, cervical smears matched to histologically proven endometrial hyperplasias and carcinomas were reviewed and compared with cervical in-situ-carcinomas/carcinomas, aiming to detail the diagnostic performance of cervical smears for upper tract and glandular lesions.
METHODS
Pathology reports of cervical smears, hysterectomies, endometrial and cervical biopsies from 1995 to 2021 were retrieved. Diagnoses of cervical smears were matched to endometrial hyperplasias and carcinomas, or cervical carcinomas and reviewed.
RESULTS
Totally 832 cervical smears (272 cervical carcinomas, 312 endometrial carcinomas, and 248 hyperplasias) were included. Considering all cytologic glandular diagnosis as positive, the detection rate of cervical adenocarcinoma-in-situ was the highest (64.3%), followed by cervical adenocarcinoma (63.8%), endometrial carcinoma (31.7%), and hyperplasia (with atypia-8.5%; without atypia-2.3%) (p < 0.001). Endometrial hyperplasia was most often diagnosed as atypical squamous cells of undetermined significance (ASCUS) (5.0%) or atypical glandular cells, not otherwise specified (3.6%) without indication of endometrial origin. For endometrial carcinomas, higher FIGO grading and endocervical involvement were associated with higher detection rates across all diagnostic categories (p = 0.002-0.028). High FIGO grade was associated with suspicious/favor neoplastic (C4) (31.1%vs10.3%, p < 0.001) and carcinoma (C5) (17.8% vs. 5.6%, p = 0.005) categories, but not for all glandular diagnoses combined (33.3% vs. 31.0%, p = 0.761).
CONCLUSION
Detection rates for endometrial lesions are lower than cervical lesions but not insignificant. Endometrial hyperplasia should be recognized as a differential of human papilloma virus-negative ASCUS and prompt consideration of investigation of the upper genital tract.
Topics: Female; Humans; Vaginal Smears; Endometrial Hyperplasia; Atypical Squamous Cells of the Cervix; Papanicolaou Test; Uterine Cervical Neoplasms; Uterine Cervical Dysplasia; Endometrial Neoplasms; Uterine Diseases; Adenocarcinoma; Carcinoma
PubMed: 37501510
DOI: 10.1002/cam4.6376 -
CytoJournal 2023The Papanicolaou's (Pap's) stain is used for cervical cancer screening. It employs toxic-carcinogenic expensive reagents, which may not be easily accessible to many...
OBJECTIVES
The Papanicolaou's (Pap's) stain is used for cervical cancer screening. It employs toxic-carcinogenic expensive reagents, which may not be easily accessible to many communities worldwide. The objective of this study was to validate the grape-based alcohol-extracted dye (Vinatela) on normal cervical samples for the Pap test.
MATERIAL AND METHODS
Samples of the two grape species were collected from two vineyards through the Agroindustrial Research Institute of Universidad Privada San Juan Bautista. The dye extraction from the grape species and the dye performance to stain cells were conducted in three phases: (a) direct staining with pre-fermentation wine products, (b) direct fragmentation of grapes and direct staining with shells of the grapes, and (c) alcoholic extraction of the dye. Vinatela obtained from two species ( "" and "") and posterior staining of cervical samples. We conducted a double-blind validation on 30 cervical samples.
RESULTS
The basophilic components of the cervical cells were stained. Alcoholic extraction staining protocol had a low yield. The nuclear and cytoplasmic borders, the nuclear details, and the polymorphonuclear nuclei were stained with Vinatela and could be differentiated during nuclear coloration. The initial staining protocol was 10- 20 min × (mean ~12 min) staining time. We noted a slightly better staining with as compared to . Malbec ( = 0.045).
CONCLUSION
Cervical cells stained with Vinatela stain from two grape species cultivated in the Southern of Peru, showed basophilic nuclear details.
PubMed: 37810437
DOI: 10.25259/Cytojournal_19_2021 -
American Journal of Preventive Medicine Jul 2024The sexual and reproductive health of cisgender women with HIV is essential for overall health and well-being. Nationally representative estimates of sexual and...
INTRODUCTION
The sexual and reproductive health of cisgender women with HIV is essential for overall health and well-being. Nationally representative estimates of sexual and reproductive health outcomes among women with HIV were assessed in this study.
METHODS
Data from the Centers for Disease Control and Prevention's Medical Monitoring Project-including data on sexual and reproductive health-were collected during June 2018-May 2021 through interviews and medical record abstraction among women with HIV and analyzed in 2023. Among women with HIV aged 18-44 years (n=855), weighted percentages were reported, and absolute differences were assessed between groups, highlighting differences ≥|5%| with CIs that did not cross the null.
RESULTS
Overall, 86.4% of women with HIV reported receiving a cervical Pap smear in the past 3 years; 38.5% of sexually active women with HIV had documented gonorrhea, chlamydia, and syphilis testing in the past year; 88.9% of women with HIV who had vaginal sex used ≥1 form of contraception in the past year; and 53.4% had ≥1 pregnancy since their HIV diagnosis-of whom 81.5% had ≥1 unintended pregnancy, 24.6% had ≥1 miscarriage or stillbirth, and 9.8% had ≥1 induced abortion. Some sexual and reproductive health outcomes were worse among women with certain social determinants of health, including women with HIV living in households <100% of the federal poverty level compared with women with HIV in households ≥139% of the federal poverty level.
CONCLUSIONS
Many women with HIV did not receive important sexual and reproductive health services, and many experienced unintended pregnancies, miscarriages/stillbirths, or induced abortions. Disparities in some sexual and reproductive health outcomes were observed by certain social determinants of health. Improving sexual and reproductive health outcomes and reducing disparities among women with HIV could be addressed through a multipronged approach that includes expansion of safety net programs that provide sexual and reproductive health service coverage.
Topics: Humans; Female; HIV Infections; Adult; Adolescent; Reproductive Health; Young Adult; Sexual Health; Sexual Behavior; Pregnancy; United States; Sexually Transmitted Diseases
PubMed: 38441506
DOI: 10.1016/j.amepre.2024.02.007