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Cureus Aug 2023Cervical cancer is the second most common cancer among women under 50 years of age in Pakistan. The current study was designed to assess the level of awareness through...
Cervical cancer is the second most common cancer among women under 50 years of age in Pakistan. The current study was designed to assess the level of awareness through educational outreach presentations about cervical cancer, Papanicolaou (Pap) smear test, and human papillomavirus (HPV) vaccination in Karachi, Pakistan. Women from different urban hospitals were enrolled. Participants participated in a 45-minute presentation on cervical cancer awareness led by student pharmacists from Nazeer Hussain University, Karachi. A pre-and post-test was administered to assess the impact of the intervention. Descriptive statistics were used to summarize the findings, and a t-test was used for matched comparison, and a p-value <0.05 for statistical significance. A total of 150 women participated in the study. The study found that Pakistani women living in urban settings were less knowledgeable about the causes of cervical cancer and prevention. After the presentation, we observed a 45% increase in knowledge, and 31% of participants said they would obtain a Pap smear test in the next six months. Supervised pharmacy student-led presentations on cervical cancer educational awareness that significantly impacted women participants. Pharmacists can play a key role in reducing cervical cancer deaths through increased awareness, education, prevention, and immunization.
PubMed: 37671214
DOI: 10.7759/cureus.42970 -
Proceedings (Baylor University. Medical... 2024Diagnosing atypical glandular cells (AGC) is a significant challenge in cytomorphology.
BACKGROUND
Diagnosing atypical glandular cells (AGC) is a significant challenge in cytomorphology.
METHODS
A retrospective study was undertaken to assess the prevalence of AGC and the subsequent histological outcomes over 5 years at a single institution.
RESULTS
A total of 159,649 ThinPrep Pap tests, including 395 cases of AGC, were retrieved, of which 330 AGC cases had follow-up histopathology. Among these 330 cases, 43.9% were classified as AGC not otherwise specified, followed by AGC-endocervical cells at 33.3%. The most frequently observed histological findings at follow-up included CIN1 and benign mucosa with reactive changes, followed by high-grade squamous intraepithelial lesion and cervical squamous cell carcinoma. The overall 5-year insignificant AGC rate was 0.12%, and the overall 5-year significant AGC rate was 0.08%. Notably, 36.7% of AGC cases tested positive for high-risk human papillomavirus. Interestingly, the level of experience did not significantly impact the rates for significant or insignificant AGC diagnosis. However, senior cytopathologists had a higher AGC report rate compared to their junior peers.
CONCLUSION
The AGC diagnostic rate at our institution falls within the range given by the College of American Pathologists. A significant number of cases had follow-up histologic results available, and the overall 5-year insignificant AGC rate was 0.12%.
PubMed: 38628324
DOI: 10.1080/08998280.2024.2324656 -
Cancers Sep 2023(1) Background: Vaginal intraepithelial neoplasia (VaIN) is a rare premalignant disease caused by persistent human papillomavirus (HPV) infection. Diagnosing VaIN is...
(1) Background: Vaginal intraepithelial neoplasia (VaIN) is a rare premalignant disease caused by persistent human papillomavirus (HPV) infection. Diagnosing VaIN is challenging; abnormal cytology and positive HPV tests are usually the first signs, but published data on their accuracy for detecting it are rare and contradictory. The aim of this study is to compare the results of hrHPV and cytology co-testing with the histological findings of the vagina. (2) Methods: In the certified Dysplasia Unit at Erlangen University Hospital, cytology and HPV samples from the uterine cervix or vaginal wall after hysterectomy were obtained between 2015 and 2023 and correlated with histological findings in biopsies from the vaginal wall. Women without vaginal biopsy findings or concomitant cervical disease were excluded. (3) Results: In all, 279 colposcopies in 209 women were included. The histological results were: benign ( = 86), VaIN I/vLSIL ( = 116), VaIN II/vHSIL ( = 41), VaIN III/vHSIL ( = 33), and carcinoma ( = 3). Accuracy for detecting VaIN was higher in women with previous hysterectomies. Positive HPV testing during colposcopy increased the likelihood for VaIN II/III/vHSIL threefold. The detection rate for VaIN III/vHSIL was 50% after hysterectomy and 36.4% without hysterectomy. (4) Conclusions: Women with risk factors for VaIN, including HPV-16 infection or prior HPV-related disease, need careful work-up of the entire vaginal wall. Hysterectomy for HPV-related disease and a history of cervical intraepithelial neoplasia (CIN) also increased the risk for VaIN II/III/vHSIL.
PubMed: 37760600
DOI: 10.3390/cancers15184633 -
Heliyon Nov 2023Cervical cancer is the second most commonly seen cancer in women. It affects the cervix portion of the vagina. The most preferred diagnostic test required for screening...
Cervical cancer is the second most commonly seen cancer in women. It affects the cervix portion of the vagina. The most preferred diagnostic test required for screening for cervical cancer is the pap smear test. Pap smear is a time-consuming test as it requires detailed analysis by expert cytologists. Cytologists can screen around 100 to 1000 slides depending upon the availability of advanced equipment. It requires substantial time and effort to carefully examine each slide, identify and classify cells, and make accurate diagnoses. Prolonged periods of visual inspection can increase the likelihood of human errors, such as overlooking abnormalities or misclassifying cells. The sheer volume of slides to be screened can exacerbate fatigue and impact diagnostic accuracy. Due to this reason Artificial intelligence (AI) based computer-aided diagnosis system for the classification and detection of pap smear images is needed. There are some AI-based solutions proposed in the literature, still, an effective and accurate system is under research. In this paper, we implement a state-of-the-art object detection model with a newly available CRIC dataset which follows the Bethesda system for nomenclature. Object detection models implemented are YOLOv5 which uses the CSPNet backbone, Faster R-CNN which has Region Proposal Network (RPN) and Detectron2 framework created by Facebook AI Research (FAIR) Group. ResNext model is implemented among the available models from Detectron2. The CRIC dataset is preprocessed and augmented using Roboflow tool. The performance measures of Average Precision and mean Average precision over the Intersection over Union (IoU) are used to evaluate the effectiveness of the models. The models performed better for two classes namely Normal and Abnormal compared to six classes from the Bethesda system. The highest mean Average Precision (mAP) is observed on the augmented dataset for YOLOv5 models for binary classification with 83 % mAP with IoU in the range of 0.50-0.95.
PubMed: 38058644
DOI: 10.1016/j.heliyon.2023.e22324 -
Journal of Cancer Education : the... Dec 2023Given ongoing gaps in adherence to Pap testing recommendations, this study examined: 1) adherence to Pap test screening recommendations; and 2) barriers to Pap test...
Given ongoing gaps in adherence to Pap testing recommendations, this study examined: 1) adherence to Pap test screening recommendations; and 2) barriers to Pap test screening among those who were nonadherent, using constructs from the Andersen model. We analyzed Spring 2022 survey data among 541 US young adults who reported having a cervix (n = 541; mean age = 27.73, 42.1% heterosexual, 57.9% sexual minority, 86.0% woman, 3.7% transgender man, 68.2% White, 31.8% racial/ethnic minority). Multivariable logistic regression examined sociodemographic correlates of nonadherence to Pap testing recommendations (i.e., no Pap testing in the past 3 years). Among those who were nonadherent, barriers to Pap testing were assessed. 68.6% (n = 371) were defined as adherent and 31.4% (n = 170) nonadherent. Multivariable regression findings indicated significant differences by race/ethnicity such that Asians (vs. Whites) were more likely to be nonadherent (OR = 2.41, CI = 1.11, 3.70, p = .021); no other differences in relation to race/ethnicity or sexual/gender identity were found. The most commonly reported barriers were: "I have not gotten around to it" (42.9%), "getting a Pap test is just not a priority for me" (30.6%), "fear/worry" (28.2%), "dislike/don't like having procedures done" (27.1%), "my healthcare provider has never mentioned it" (21.2%), "haven't had sex so I don't consider myself at high risk" (20.6%), and "COVID-19 pandemic prevented me" (15.3%). Pap testing is underutilized among young adults in the US, particularly Asians. Multilevel interventions must address barriers within the healthcare system (e.g., provider recommendation), external environment (e.g., societal factors), and individual realm (e.g., perceptions).
Topics: Female; Young Adult; Humans; Male; Papanicolaou Test; Ethnicity; Pandemics; Gender Identity; Minority Groups; Uterine Cervical Neoplasms; Vaginal Smears; Early Detection of Cancer
PubMed: 37440165
DOI: 10.1007/s13187-023-02340-6 -
Journal of Adolescent and Young Adult... Jun 2024The aim of this study is to reveal female university students' knowledge and perceptions about cervical cancer (CC) and human papillomavirus (HPV), and relationship...
The aim of this study is to reveal female university students' knowledge and perceptions about cervical cancer (CC) and human papillomavirus (HPV), and relationship with e-health literacy (e-HL). It also aims to determine the predictors affecting CC and HPV. A cross-sectional study was conducted with 589 female university students in Türkiye. Data were collected using a "Cervical Cancer and HPV Awareness Questionnaire" and an "E-health Literacy Scale (e-HLS)." Analysis involved Pearson correlation analysis, Independent Sample -test, one-way analysis of variance, and Linear Regression analysis. Results indicate that female students exhibited a low level of knowledge and perception about CC and HPV. Only 2.90% of students reported being vaccinated, while 39.90% had sexual experience. Higher knowledge levels were observed among married individuals, those familiar with HPV and the HPV vaccine, those who had undergone Pap smear tests, sexually active individuals, and consistent condom users. e-HL had a positive impact on knowledge and perceived threat about CC and HPV. The affecting predictors for knowledge about CC and HPV were found to be e-HLS (β = 0.911), having prior knowledge of HPV (β = 0.201), and being aware of the HPV vaccine (β = 0.172). In terms of perceived threat, the affecting predictors were e-HLS (β = 0.207), having heard of HPV (β = 0.101), and having knowledge of the HPV vaccine (β = 0.092). e-HL emerged as a crucial predictor positively influencing knowledge and perceptions about CC and HPV. This suggests the potential for organizing digital health campaigns to enhance awareness and understanding of CC and HPV.
Topics: Humans; Female; Uterine Cervical Neoplasms; Health Literacy; Health Knowledge, Attitudes, Practice; Students; Young Adult; Universities; Adult; Cross-Sectional Studies; Papillomavirus Infections; Adolescent; Surveys and Questionnaires; Papillomaviridae; Perception; Human Papillomavirus Viruses
PubMed: 38394226
DOI: 10.1089/jayao.2023.0173 -
BMC Women's Health Nov 2023Cervical cancer is the fourth most diagnosed cancer among women globally, with much of the burden being carried by women in limited-resource settings often worsened by...
INTRODUCTION
Cervical cancer is the fourth most diagnosed cancer among women globally, with much of the burden being carried by women in limited-resource settings often worsened by the high prevalence of HIV. Furthermore, the COVID-19 pandemic disrupted organized screening efforts and HIV management regimens worldwide, and the impact of these disruptions have not been examined in these settings. The purpose of this paper is to describe whether uptake of cervical cancer screening and HIV management changed before, during, and since the COVID-19 pandemic in North-Central Nigeria.
METHODS
Longitudinal healthcare administration data for women who obtained care between January 2018 and December 2021 were abstracted from the AIDS Prevention Initiative Nigeria (APIN) clinic at Jos University Teaching Hospital. Patient demographics, pap smear outcomes, and HIV management indicators such as viral load and treatment regimen were abstracted and assessed using descriptive and regression analyses. All analyses were conducted comparing two years prior to the COVID-19 pandemic, the four quarters in 2020, and the year following COVID-19 restrictions.
RESULTS
We included 2304 women in the study, most of whom were between 44 and 47 years of age, were married, and had completed secondary education. About 85% of women were treated with first line highly active retroviral therapy (HAART). Additionally, 84% of women screened using pap smear had normal results. The average age of women who sought care at APIN was significantly lower in Quarter 3, 2020 (p = 0.015) compared to the other periods examined in this study. Conversely, the average viral load for women who sought care during that period was significantly higher in adjusted models (p < 0.0001). Finally, we determined that the average viral load at each clinic visit was significantly associated with the period in which women sought care.
CONCLUSIONS
Overall, we found that COVID-19 pandemic mitigation efforts significantly influenced women's ability to obtain cervical cancer screening and routine HIV management at APIN clinic. This study buttresses the challenges in accessing routine and preventive care during the COVID-19 pandemic, especially in low-resource settings. Further research is needed to determine how these disruptions to care may influence long-term health in this and similar at-risk populations.
Topics: Female; Humans; Uterine Cervical Neoplasms; HIV Infections; Vaginal Smears; Early Detection of Cancer; Nigeria; Pandemics; COVID-19; Papanicolaou Test; Mass Screening
PubMed: 38037005
DOI: 10.1186/s12905-023-02782-6 -
Scientific Reports Jul 2023
PubMed: 37407808
DOI: 10.1038/s41598-023-37880-w -
Journal of Obstetrics and Gynaecology... Oct 2023Cervical cancer (CC) is a public health problem because of its increasing prevalence and mortality in low- and middle-income countries.
BACKGROUND
Cervical cancer (CC) is a public health problem because of its increasing prevalence and mortality in low- and middle-income countries.
OBJECTIVE
To study knowledge, attitudes, and practices about CC and screening among women in a referral hospital in Côte d'Ivoire, a sub-Saharan African country.
MATERIALS AND METHODS
A cross-sectional study, from September 1, 2020 to March 1, 2021, in the obstetric gynecology consultation unit of the University Hospital of Cocody. It included patients who gave informed consent. Data were collected using a questionnaire. Data analysis was performed using Epi data 3.1 software (CDC Atlanta-USA).
RESULTS
1200 women were included (47.2%) with a mean age of 32 years. General knowledge ranged from 6.2 to 32.7% and main risk factors were advanced age (75.2%), HIV infection (60.3%), early marriage (38.2%), and multiple sexual partners (25.8%). 975 women were able to provide a response (81.3%). 85.2% of women identified signs and symptoms: vaginal bleeding (83.6%), intermenstrual bleeding (65.1%), and foul-smelling discharge (11.9%). The level of knowledge of screening was 79% for PAP smear, 72.6% for VIA and 14.2% for LBC. A positive attitude was observed since 87.8% declared they wanted to perform screening. A significant practice (60.4%) was demonstrated, and the screening tests used were visual inspection with acetic acid (52.6%), Pap smear (39.8%) and liquid-based cytology (7.6%).
CONCLUSION
We revealed a good knowledge of reality of CC, but effective information, education and communication strategies are needed to improve the level of awareness about risk factors, symptoms and preventive methods.
PubMed: 37916010
DOI: 10.1007/s13224-023-01816-1 -
BMC Primary Care Aug 2023The aims of the "médecin traitant" or referring physician (RP) reform, introduced in France in 2004, were to improve the organisation and quality of care and to allow...
BACKGROUND
The aims of the "médecin traitant" or referring physician (RP) reform, introduced in France in 2004, were to improve the organisation and quality of care and to allow for greater equity, particularly in terms of prevention. The objective of our study was to evaluate the effect of having a declared RP on the uptake of screening for breast and cervical cancers, and to explore the mechanisms involved.
METHODS
We used an existing dataset of 1,072,289 women, which combines data from the Health Insurance information systems, with census data. We built multivariable logistic regression models to study the effect of having a RP on the uptake of mammography and pap smear, adjusted for age, socio-economic level, health status and healthcare provision. We secondarily added to this model the variable "having consulted a General Practitioner (GP) within the year". Finally, we evaluated the interaction between the effect of having a referring physician and the area of residence (metropolitan/urban/rural).
RESULTS
Patients who had a declared RP had a significantly higher uptake of mammography and pap smear than those who did not. The strength of the association was particularly important in very urban areas. The effect of having visited a GP seemed to explain a part of the correlation between having a RP and uptake of screening.
CONCLUSIONS
Lower rates of gynaecological screening among women without an RP compared to those with an RP may partly reflect a specific behaviour pattern in women less adherent to the health care system. However, this result also shows the importance of the RP, who assumes the key role of relaying public health information in a more personalised and adapted way.
Topics: Humans; Female; Early Detection of Cancer; Cross-Sectional Studies; Uterine Cervical Neoplasms; General Practitioners; France
PubMed: 37644404
DOI: 10.1186/s12875-023-02122-5