-
Ecancermedicalscience 2023Cervical cancer is the fourth most frequent malignancy and common cause of mortality in women worldwide, despite being one of the most preventable female cancers.
BACKGROUND
Cervical cancer is the fourth most frequent malignancy and common cause of mortality in women worldwide, despite being one of the most preventable female cancers.
OBJECTIVES
The aim of the study was to assess the awareness and knowledge of patients about cervical cancer prevention methods and the use of these methods by women in an urban setting.
METHOD
A cross-sectional study design was employed. A census was conducted to include all women ( = 153) who met the inclusion criteria and attended the gynaecology clinic of the Cape Coast Teaching Hospital from May to July 2022 for various gynaecological reasons. Data were collected using a structured questionnaire adapted from the Cervical Cancer Knowledge Prevention-64.
RESULTS
The mean age was 40.0 years and ranges between 18 and 78 years. The majority of study participants had at least a secondary school level of education (78.8%), and almost all had at least a primary school education (95.4%). Most of the respondents (64.7%) were not aware of cervical cancer. Among those who had awareness, 64.8% of them knew about the existence of prevention methods; pap smear was the most common known method of prevention. There was a statistically significant association between the respondent's educational level and knowledge of the existence of cervical cancer prevention methods and the usage of pap smear. Only 16.3% of our study population has ever used a preventive method.
CONCLUSION
More than half of the participants were not aware of cervical cancer and its preventive methods, and those who were aware had insufficient knowledge, which translated to very low usage of cervical cancer preventive methods. There is an urgent need to intensify public education on cervical cancer.
PubMed: 38414947
DOI: 10.3332/ecancer.2023.1626 -
Cureus Apr 2024Background Anal Pap smears are imperative to screening for human papillomavirus (HPV)-associated anal squamous cell cancers, particularly in patients living with human...
Background Anal Pap smears are imperative to screening for human papillomavirus (HPV)-associated anal squamous cell cancers, particularly in patients living with human immunodeficiency virus (HIV) given a higher incidence of disease. Self-collection of specimens may be favored by patients and more feasible to collect, increasing screening. Methods This was a single-center observational cohort study at a single academic medical center Infectious Diseases clinic from October to December 2021. We aimed to improve compliance of anal Pap collection documentation of "self-collected" versus "physician-collected" as well as verify if self-collected specimens (SCS) were adequate for interpretation equivalent to physician-collected specimens (PCS). Additionally, we aimed to evaluate patient and provider satisfaction with self-collected anal Paps. Results Sixty anal Pap smears were available for evaluation. The rate of documentation of the collection method (self-collected vs. physician-collected) was 88% during the intervention. A total of 75% of patients opted for self-collection, and 35/45 (78%) of these samples were adequate for interpretation. There was no difference in the adequacy of specimen (the ability of a cytopathologist to interpret the specimen) between the SCS and PCS. Conclusion Limited prior data suggest self-collected anal Pap specimens are adequate for interpretation only slightly less often than PCS. In our small cohort, there was no statistically significant difference between collection methods. Satisfaction with self-collection of specimens was high for both patients and providers. Additional validation in more diverse/larger clinical settings may be helpful to support this practice.
PubMed: 38779240
DOI: 10.7759/cureus.58753 -
Diagnostics (Basel, Switzerland) Sep 2023One of the most common types of cancer among in women is cervical cancer. Incidence and fatality rates are steadily rising, particularly in developing nations, due to a...
One of the most common types of cancer among in women is cervical cancer. Incidence and fatality rates are steadily rising, particularly in developing nations, due to a lack of screening facilities, experienced specialists, and public awareness. Visual inspection is used to screen for cervical cancer after the application of acetic acid (VIA), histopathology test, Papanicolaou (Pap) test, and human papillomavirus (HPV) test. The goal of this research is to employ a vision transformer (ViT) enhanced with shifted patch tokenization (SPT) techniques to create an integrated and robust system for automatic cervix-type identification. A vision transformer enhanced with shifted patch tokenization is used in this work to learn the distinct features between the three different cervical pre-cancerous types. The model was trained and tested on 8215 colposcopy images of the three types, obtained from the publicly available mobile-ODT dataset. The model was tested on 30% of the whole dataset and it showed a good generalization capability of 91% accuracy. The state-of-the art comparison indicated the outperformance of our model. The experimental results show that the suggested system can be employed as a decision support tool in the detection of the cervical pre-cancer transformation zone, particularly in low-resource settings with limited experience and resources.
PubMed: 37761252
DOI: 10.3390/diagnostics13182884 -
Journal of Immigrant and Minority Health Dec 2023This study aims to determine whether a novel cervical cancer screening toolkit will increase rates of pap test completion and HPV vaccination among Somali women living... (Randomized Controlled Trial)
Randomized Controlled Trial
This study aims to determine whether a novel cervical cancer screening toolkit will increase rates of pap test completion and HPV vaccination among Somali women living in the United States. We conducted a randomized controlled, pilot trial from June 2021 to February 2022. Somali women aged 21 to 70 were randomized to either receive a toolkit (infographic, video and an in-person health seminar) or not. Health passports confirming a completed pap test and/or HPV vaccination by clinician signature were used to measure outcomes. The primary outcome was pap test completion and the secondary outcome was HPV vaccination. We enrolled 57 participants. Patients randomized to the treatment arm were significantly more likely to have had a pap test (53.7% vs. 3.7%, p < 0.0001) and were also more likely to have received the HPV vaccine (10.7% vs. 3.7%, p = 0.6110). This toolkit increased rates of pap test completion and more participants in the intervention arm received HPV vaccination, though numbers were low. The study design may serve as a reproducible model to determine the effectiveness of patient education materials.
Topics: Humans; Female; United States; Uterine Cervical Neoplasms; Early Detection of Cancer; Pilot Projects; Somalia; Papillomavirus Infections; Papanicolaou Test; Papillomavirus Vaccines; Vaginal Smears; Mass Screening
PubMed: 37071376
DOI: 10.1007/s10903-023-01455-8 -
Cureus May 2024The evolutionary journey of cervical cancer screening has been a major medical success story, considering the substantial role it has played in dwindling the disease... (Review)
Review
The evolutionary journey of cervical cancer screening has been a major medical success story, considering the substantial role it has played in dwindling the disease burden. Through sustained collaborative efforts within the medical community, significant advances have been made from the humble yet path-breaking conventional Pap smear to the current automated screening systems and human papillomavirus (HPV) molecular testing. With the integration of artificial intelligence into screening techniques, we are currently at the precipice of circumventing the pitfalls of manual cytology readings and improving the efficiency of the screening systems by a significant margin. Despite the technological milestones traversed, the high logistics and operational cost, besides the technical know-how of operating the automated systems, can pose a major practical challenge in the widespread adoption of these advanced techniques in cervical cancer screening programs. This would suggest the need to adopt strategies that are tailored to the demands and needs of the different settings keeping their limitations in mind. This review aims to take the reader through the entire evolutionary journey of cervical cancer screening programs, highlight the individual merits and demerits of each technique, and discuss the recommendations from the major global guidelines.
PubMed: 38903362
DOI: 10.7759/cureus.60769 -
Cancer Causes & Control : CCC Jan 2024While various interventions have been conducted to decrease cervical cancer's burden in Nigeria, no study has examined the trends in cervical cancer screening uptake...
BACKGROUND
While various interventions have been conducted to decrease cervical cancer's burden in Nigeria, no study has examined the trends in cervical cancer screening uptake over time. The present study sought to fill this gap in knowledge using data collected at Jos University Teaching Hospital (JUTH) in Nigeria.
METHODS
Data collected continuously between 2006 and 2016 were analyzed to identify trends in screening uptake, changes in risk factors for cervical cancer, and to identify factors for women screened at Jos University Teaching Hospital (JUTH) in Jos, Nigeria. Categorical analyses and logistic regression models were used to describe patient characteristics by year, and to identify factors associated with repeated screening uptake.
RESULTS
A total of 14,088 women who were screened between 2006 and 2016 were included in the database; 2,800 women had more than one screening visit. Overall, screening uptake differed significantly by year. On average women were first screened at age 38. About 2% of women screened were women living with HIV. Most women (86%) had normal pap smear at first screening, with the greatest decreased risk of abnormalities observed between 2011 and 2014. Odds of a follow-up screening after a normal result decreased significantly between 2008 and 2016 compared to women screened in 2006 and 2007. Finally, women living with HIV had increased odds of follow-up screening after having a normal pap smear.
CONCLUSIONS
These findings contribute to our understanding of the potential social and health system barriers to cervical cancer control in Nigeria. The findings may assist policy makers to design interventions to increase access and compliance to recommended screening schedules in this vulnerable population.
Topics: Female; Humans; Adult; Male; Uterine Cervical Neoplasms; Vaginal Smears; Early Detection of Cancer; Nigeria; Papanicolaou Test; Mass Screening; Health Knowledge, Attitudes, Practice; HIV Infections
PubMed: 37530986
DOI: 10.1007/s10552-023-01764-1 -
BMC Infectious Diseases Feb 2024The human papillomavirus (HPV) infection may affect the miRNA expression pattern during cervical cancer (CC) development. To demonstrate the association between...
Hsa-miR-194-5p and hsa-miR-195-5p are down-regulated expressed in high dysplasia HPV-positive Pap smear samples compared to normal cytology HPV-positive Pap smear samples.
BACKGROUND
The human papillomavirus (HPV) infection may affect the miRNA expression pattern during cervical cancer (CC) development. To demonstrate the association between high-risk HPVs and the development of cervix dysplasia, we examined the expression patterns of hsa-miR-194-5p and hsa-miR-195-5p in Pap smear samples from southeast Iranian women. We compared samples that were HPV-positive but showed no abnormality in the cytological examination to samples that were HPV-positive and had severe dysplasia.
METHODS
Pap smear samples were obtained from 60 HPV-positive (HPV-16/18) patients with histologically confirmed severe dysplasia (cervical intra-epithelial neoplasia (CIN 3) or carcinoma in situ) and the normal cytology group. The expression of hsa-miR-194-5p and hsa-miR-195-5p was analyzed by real-time quantitative PCR, using specific stem-loop primers and U6 snRNA as the internal reference gene. Clinicopathological features were associated with miRNA expression levels. Furthermore, functional enrichment analysis was conducted using in silico tools. The Kaplan-Meier survival method was also obtained to discriminate survival-significant candidate miRNAs in CC, and receiver operating characteristic (ROC) curves were constructed to assess the diagnostic value.
RESULTS
Compared to HPV-positive cytologically normal Pap smear samples, hsa-miR-194-5p and hsa-miR-195-5p relative expression decreased significantly in HPV-positive patients with a severe dysplasia Pap smear. Kaplan-Meier analysis indicated a significant association between the miR-194 decrease and poor CC survival. In essence, ROC curve analysis showed that miR-194-5p and miR-195-5p could serve as valuable markers for the development of cervix dysplasia in individuals who are positive for high-risk HPVs.
CONCLUSIONS
This study revealed that hsa-miR-194-5p and hsa-miR-195-5p may possess tumor suppressor capabilities in the context of cervical dysplasia progression. However, it remains uncertain whether these microRNAs are implicated in the transition of patients with high dysplasia to cervical cancer. We also showed the potential capability of candidate miRNAs as novel diagnostic biomarkers related to cervical dysplasia progression.
Topics: Humans; Female; Uterine Cervical Neoplasms; Papanicolaou Test; Papillomavirus Infections; Human papillomavirus 16; Cytology; Iran; Human papillomavirus 18; MicroRNAs; Uterine Cervical Dysplasia
PubMed: 38342922
DOI: 10.1186/s12879-023-08942-1 -
AIDS Patient Care and STDs Apr 2024
Topics: Humans; Female; Papanicolaou Test; HIV Infections; Adult; Middle Aged; United States; Mammography; Breast Neoplasms; Patient Acceptance of Health Care; Early Detection of Cancer; Uterine Cervical Neoplasms; Vaginal Smears; Outpatients; Mass Screening
PubMed: 38656216
DOI: 10.1089/apc.2024.0010 -
Ciencia & Saude Coletiva Nov 2023This article aims to evaluate the performance of preconception health indicators according to sociodemographic characteristics among Brazilian women of reproductive age....
This article aims to evaluate the performance of preconception health indicators according to sociodemographic characteristics among Brazilian women of reproductive age. We conducted a descriptive epidemiological study using data from 21,645 and 25,228 women, respectively, who responded the 2013 and 2019 national health surveys, and data for the period 2010 to 2020 derived from the national health system's Department of Informatics (DATASUS). We calculated the prevalence of indicators according to sociodemographic characteristics and statistical significance of differences was measured using Pearson's chi-squared test. Syphilis and HIV incidence rates were also calculated. There was an increase in the prevalence of access to health service indicators (medical and dental consultations and recent Pap smear). However, there was an increase in the prevalence of hypertension, alcohol use, and obesity. The prevalence of use of contraceptive methods and fertility treatment remained stable. Syphilis incidence increased sevenfold between 2010 and 2020. Black/brown women with a low level of education, higher parity, and living in the North or Northeast performed worse for preconception health indicators. Despite the increase in access to health services, performance on preconception health indicators declined and health inequities continued.
Topics: Pregnancy; Humans; Female; Preconception Care; Syphilis; Prevalence; Brazil; Contraception
PubMed: 37971017
DOI: 10.1590/1413-812320232811.16282022 -
BMC Women's Health Jul 2023Despite efforts to increase cervical cancer screening access in rural Bolivia, uptake remains low. Bolivia has one of the highest cervical cancer mortality rates in the...
BACKGROUND
Despite efforts to increase cervical cancer screening access in rural Bolivia, uptake remains low. Bolivia has one of the highest cervical cancer mortality rates in the Americas. As it redoubles efforts to deliver Universal Health Care, the Bolivian government needs information on the factors constraining cervical cancer screening access and utilization, especially in rural areas.
METHODS
Our qualitative study explored cervical cancer screening barriers and described community and provider perceptions and experiences of care. Bolivian and US researchers analyzed data collected from eight focus groups with male and female community members (n = 80) and interviews with healthcare providers (n = 6) in four purposively selected rural communities in Hernando Siles, Bolivia. Deductive and inductive codes were used to thematically analyze data using MaxQDA software.
RESULTS
Four themes emerged from the data: lack of knowledge/misconceptions, health system inadequacy, lack of confidence in providers, and opportunities for improvement. Both men and women displayed misconceptions about the causes of cervical cancer, its consequences, the recommended screening frequency, and the means of accessing care. Providers noted community members' lack of knowledge and low risk-perception as utilization barriers but also highlighted poor health service quality and inconsistent health education as factors. Poor healthcare quality was a significant barrier; this included poor patient-provider communication, lack of transportation to screening facilities, and severe delays in receiving test results. Providers also noted problems with provider training and physical space for screening. Community members reported low confidence in nurses to perform screening, preferring doctors and specialists. They also expressed discomfort in having male healthcare providers conduct screening. Suggestions for improvements included more intensive cervical cancer outreach to rural areas and having specialists train lower-level providers to perform screening.
CONCLUSIONS
Our findings suggest that poor healthcare quality has affected screening uptake in addition to physical barriers to care. They indicate a need for initiatives to reduce reporting time for Pap test results, the incorporation of community-based HPV self-sampling into screening protocols, and the implementation of programs to improve community confidence in providers' ability to perform screening.
Topics: Female; Male; Humans; Uterine Cervical Neoplasms; Bolivia; Early Detection of Cancer; Rural Population; Qualitative Research; Mass Screening
PubMed: 37407967
DOI: 10.1186/s12905-023-02500-2