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Journal of Obstetrics and Gynaecology :... Aug 2022Cervical cancer is one of the five most common cancers among women. The present study aimed to compare conventional and liquid-based Pap smear methods in 2018 in Kerman,...
Cervical cancer is one of the five most common cancers among women. The present study aimed to compare conventional and liquid-based Pap smear methods in 2018 in Kerman, Iran. This was a cross-sectional study. Pap smear samples (conventional Pap smear (CN) and liquid-based cytology (LBC)) were collected from five health centres in Kerman. Samples were classified into two groups of liquid and CNs, and each group was classified into normal, abnormal (including, atypical squamous cells of undetermined significance (ASCUS), atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) and cancer) and unsatisfactory. Descriptive data analysis and chi-square/Fisher's exact test were performed in SPSS 20 (SPSS Inc., Chicago, IL). Totally, 31,513 women were screened by two CN and LBC. The mean age of subjects was 39.73 ± 9.58 years. The unsatisfactory smears (1.4% versus 0.02%; =.001) and ASCUS (45.1% versus 39.4%; =.007) were more reported by conventional tests, while LSIL (33.1% versus 38.9%; =.005) was reported by the LBC test. Among women who were younger than 40 years, the CIN2 that was found by LBC was significantly more than the CN method (37.4% versus 31.7, =.04) and among older women (older than 40 years) the CIN1 was significantly more as well (18% versus 13.6%, =.05). The present study showed that, although LBC had many advantages, CN is still useful. Further studies are to be suggested as a clinical trial in another population with a large number of participants to compare the diagnosing methods of cervical cancers. Impact Statement The conventional Pap smear (CN) and liquid-based cytology (LBC) methods are the most common methods for screening cervical cancers. Previously, in some studies, LBC was reported as a better method and in some studies, traditional method was preferred. Conflicting results were found in previous articles. LBC compared to CN could find truer abnormal cases. The superiority of the LBC method is seen in cases such as reducing unsatisfactory cases, etc. LBC compared to CN could find more CIN. Also, LBC could find more CIN1 among women older than 40 years and more CIN ≥2 among younger women. Although LBC has many advantages and it is easier, CN is still useful and both methods are suitable for cervical abnormality and cancer detection. CN cannot be declared an outdated method.
Topics: Adult; Aged; Atypical Squamous Cells of the Cervix; Cross-Sectional Studies; Female; Humans; Middle Aged; Papanicolaou Test; Precancerous Conditions; Squamous Intraepithelial Lesions; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35579303
DOI: 10.1080/01443615.2022.2049721 -
Journal of the College of Physicians... Sep 2023To evaluate the conization results performed due to human papillomavirus (HPV), smear, colposcopy results or clinician's decision and determine the factors that predict...
OBJECTIVE
To evaluate the conization results performed due to human papillomavirus (HPV), smear, colposcopy results or clinician's decision and determine the factors that predict ≥CIN2.
STUDY DESIGN
Retrospective comparative study. Place and Duration of the Study: Department of Gynaecology and Obstetrics, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey, between January 2011 and December 2021.
METHODOLOGY
Women with known HPV results who underwent conization in the Gynaecology clinic were retrospectively included. Age, HPV genotypes, conization, and colposcopy results of the patients were recorded. Patients were divided into two groups as those with and without ≥CIN2 and compared in terms of clinicopathological features.
RESULTS
Four hundred and twenty eight (82.8%) of the 517 patients were premenopausal and perimenopausal, and 89 (17.2%) of the patients with a median age of 42 years (range: 30-65 years) were postmenopausal. While 374 were HPV 16/18 positive, 143 were non-16/18 HPV positive. Conization result was normal in 202 (39.1%) patients, CIN1 in 129 (25.0%) patients, and CIN 2-3 in 186 (36.0%) patients. In the HPV 16/18 positive group, conization result was normal in 38.2% of patients, CIN1 in 20.9%, and CIN 2-3 in 40.9%; these rates were 41.3%, 35.7%, and 23.1% in the HPV-other group, respectively (p <0.001). In the logistic regression model, age, HPV type (16/18), and smear cytology results (≥ASC-US) were tested as independent factors predicting ≥CIN2.
CONCLUSION
HPV 16/18 positivity and smear cytology result (≥ASC-US) were the factors predicting ≥CIN2. Smear and HPV genotyping can make an important contribution to detecting false
KEY WORDS
CIN, Colposcopy, Conization, Cervix, Cervical cancer, Neoplasia, HPV.
Topics: Pregnancy; Humans; Female; Adult; Middle Aged; Aged; Retrospective Studies; Colposcopy; Conization; Papanicolaou Test; Genotype; Human papillomavirus 16; Papillomavirus Infections; Human papillomavirus 18; Papillomaviridae; Human Papillomavirus Viruses
PubMed: 37691356
DOI: 10.29271/jcpsp.2023.09.972 -
Diagnostic Cytopathology Apr 2021Cervical cancer progresses slowly, increasing the chance of early detection of pre-neoplastic lesions via Pap exam test and subsequently preventing deaths. However, the... (Review)
Review
BACKGROUND
Cervical cancer progresses slowly, increasing the chance of early detection of pre-neoplastic lesions via Pap exam test and subsequently preventing deaths. However, the exam presents both false-negatives and false-positives results. Therefore, automatic methods (AMs) of reading the Pap test have been used to improve the quality control of the exam. We performed a literature review to evaluate the feasibility of implementing AMs in laboratories.
METHODS
This work reviewed scientific publications regarding automated cytology from the last 15 years. The terms used were "Papanicolaou test" and "Automated cytology screening" in Portuguese, English, and Spanish, in the three scientific databases (SCIELO, PUBMED, MEDLINE).
RESULTS
Of the resulting 787 articles, 34 were selected for a complete review, including three AMs: ThinPrep Imaging System, FocalPoint GS Imaging System and CytoProcessor. In total, 1 317 148 cytopathological slides were evaluated automatically, with 1 308 028 (99.3%) liquid-based cytology slides and 9120 (0.7%) conventional cytology smears. The AM diagnostic performances were statistically equal to or better than those of the manual method. AM use increased the detection of cellular abnormalities and reduced false-negatives. The average sample rejection rate was ≤3.5%.
CONCLUSION
AMs are relevant in quality control during the analytical phase of cervical cancer screening. This technology eliminates slide-handling steps and reduces the sample space, allowing professionals to focus on diagnostic interpretation while maintaining high-level care, which can reduce false-negatives. Further studies with conventional cytology are needed. The use of AM is still not so widespread in cytopathology laboratories.
Topics: Automation, Laboratory; Female; Humans; Papanicolaou Test; Uterine Cervical Neoplasms
PubMed: 33548162
DOI: 10.1002/dc.24708 -
African Journal of Reproductive Health Jul 2022Exploring the women's intention of the core self-directed behaviors for cervical cancer prevention and their confident abilities for engagement is of utmost importance...
Exploring the women's intention of the core self-directed behaviors for cervical cancer prevention and their confident abilities for engagement is of utmost importance for targeted intervention development. This study investigates the Saudi women's intention and self-efficacy for Pap Smear Screening and HPV Vaccination in Najran city, KSA. It was a descriptive cross-sectional study incorporating a convenient sample of 1085 Saudi women through a social media-based four-part questionnaire: Basic Data and Reproductive Health History, Pap Smear Intention Scale, HPV vaccination intention scale, Self-Efficacy Scale for Pap smear testing, and HPV vaccination. The results indicated that 59.5% of the study participants had a low intention for Pap testing, while 62.5% of them had a high intention to receive the HPV vaccine, and the self-efficacy for both was high among 57.0% of them. Binary logistic regression showed higher odds for Pap testing intention among older women with enough family income and those with no history of Pap testing and higher gravidity and parity. Rural resident women and those having no family history of CC have Lower odds for HPV vaccination intention. Women of reproductive age and those with high gravidity and parity have higher odds. Self-efficacy has lower odds among divorced, rural resident women and those with no history of Pap testing or HPV vaccine; however, women with longer marriage duration and higher gravidity and parity had higher odds. Hence, there is an apparent high intention for HPV vaccination with a low intention for Pap testing among Saudi women in Najran despite having a higher self-efficacy. These necessitate establishing consolidated efforts for awareness-raising and advocacy programs to prevent CC.
Topics: Pregnancy; Female; Humans; Aged; Papanicolaou Test; Vaginal Smears; Human Papillomavirus Viruses; Intention; Self Efficacy; Papillomavirus Infections; Cross-Sectional Studies; Saudi Arabia; Uterine Cervical Neoplasms; Vaccination; Papillomavirus Vaccines; Early Detection of Cancer; Health Knowledge, Attitudes, Practice; Mass Screening
PubMed: 37585011
DOI: 10.29063/ajrh2022/v26i7s.7 -
Asian Pacific Journal of Cancer... Oct 2022Although various improvements have been made in the reporting of the Papanicolaou (PAP) test in recent years, there remain several challenges that have yet to be...
BACKGROUND
Although various improvements have been made in the reporting of the Papanicolaou (PAP) test in recent years, there remain several challenges that have yet to be addressed in terms of determining a standardized methodology for categorizing atypical squamous cells of undetermined significance (ASC US).
METHODS
The present study focuses on evaluating the performance of the methylation status of two genes (CGB3 and NOP56) using a total of 200 PAP samples, which were divided into the "determined" group, with 78 samples based on cytology, and the "undetermined" group (ASC US), with 122 samples. The promoter methylation status of the CGB3 and NOP56 genes was detected for the 200 PAP samples using methylation specific PCR (MSP). The diagnostic abilities of the CGB3 and NOP56 genes in PAP samples were measured, and receiver operating characteristic (ROC) curves were generated using Python programming language.
RESULTS
Based on the validation of CGB3 and NOP56 methylation in the 200 PAP samples, both genes exhibited higher methylation percentages in abnormal samples compared with normal samples. In addition, on the basis of diagnostic performance analysis, the CGB3 gene exhibited the highest sensitivity and specificity in both histology based ASC US and cytology based 'determined' PAP samples, with significant diagnostic abilities [area under the curve (AUC) values of 0.83 and 0.74, respectively, where AUC ≥0.5 was determined to be significant] to distinguish between the "normal" and "abnormal" samples.
CONCLUSION
The findings of the present study will contribute toward identifying a DNA methylation marker for the early detection of abnormal samples before they reach the initial stages of cervical cancer, and should prove to be helpful for clinicians in terms of diagnosing patients whose cells are ASC US.
.Topics: Female; Humans; Papanicolaou Test; Atypical Squamous Cells of the Cervix; Vaginal Smears; Uterine Cervical Neoplasms; DNA Methylation; Papillomavirus Infections; Uterine Cervical Dysplasia
PubMed: 36308381
DOI: 10.31557/APJCP.2022.23.10.3541 -
International Journal of STD & AIDS Oct 2022To describe risk factors/incidence of abnormal cervical/vaginal cytology/histology and cancer among women living with human immunodeficiency virus (WLHIV) ≥65 years...
OBJECTIVES
To describe risk factors/incidence of abnormal cervical/vaginal cytology/histology and cancer among women living with human immunodeficiency virus (WLHIV) ≥65 years compared to HIV-negative matched controls.
STUDY DESIGN
Retrospective cohort of patients who underwent Pap screening at the University of Maryland 01/2003-04/2019.
RESULTS
WLHIV and HIV-negative controls ( = 70 each) underwent 140/151 Pap tests, respectively. Among WLHIV, 29% exhibited abnormal results and were less likely than HIV-negative women with normal Paps to have had serially negative Pap tests prior to age 65 ( = .03). In both groups, 1.4% developed cervical cancer. Abnormal Paps were more frequent in WLHIV than in HIV-negative women (31% vs 10%, < .0001, RR:3.2, 95%CI1.9-5.4) as was HRHPV (high-risk human papillomavirus) status (43% vs 19%, = .0233, RR:2.3, 95%CI1.2-4.6). The RR for an abnormal Pap was 2.6 (95% CI:1.1-4.2) for VL >1000 copies/mL and 0.4 (95% CI:0.2-0.7) for CD4 count of >200 cells/μL. No individual with an initially normal Pap experienced an abnormal result over a mean of 42.5 and 43.5 months in the HIV-positive and HIV-negative groups, respectively.
CONCLUSIONS
HIV status was associated with a higher rate of abnormal Pap/HRHPV; however, no significant difference in cervical/vaginal cancer. Elevated VL/low CD4 count were associated with greater risk for an abnormal Pap.
Topics: Aged; Female; HIV Infections; Humans; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Retrospective Studies; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35980835
DOI: 10.1177/09564624221111280 -
BMC Women's Health Apr 2022Cervical cancer is one of the leading malignancies globally and has taken third place in Namibia amongst women aged 15-44 years. Infection with the Human...
BACKGROUND
Cervical cancer is one of the leading malignancies globally and has taken third place in Namibia amongst women aged 15-44 years. Infection with the Human Immunodeficiency Virus (HIV) has been proven to increase women's susceptibility to developing cervical carcinoma. Sadly, Namibia carries a twin burden of HIV and cervical cancer. Namibians are aware of HIV/AIDS, but remain poorly informed about cervical cancer. Furthermore, among those who are aware of the disease, low utilisation of screening tests have been reported.
OBJECTIVE
The purpose was to explore perceptions and attitudes held by women about cervical cancer, reasons for low uptake of Pap smear testing amongst those who are aware of the malignancy as well as unearth motivation factors that has fuelled women to go for screening.
METHODOLOGY
A descriptive, cross-sectional study was conducted using convenience sampling as a sampling technique. The survey instrument used was a self-administered questionnaire. It consisted of both closed and open ended questions. A total of 136 women were surveyed.
RESULTS AND CONCLUSION
The level of awareness for cervical cancer (92.6%) and Pap smear (93.4%) were high. Most were able to identify that Pap smear test is used for screening for pre-cancerous lesions. However, knowledge about the impact of a HIV positive status along with co infection with HPV as the leading causes for progression of invasive cervical carcinoma was not well known. Knowledge about the other risk factors such as multiple sexual partners (39.7%), early sex debut (34.9%) and smoking was poorly demonstrated. This suggests that a high awareness level does not necessarily translate into having a good perception or understanding of a disease. A good attitude towards screening was observed although less than half of the study population reported ever having a test done.
Topics: Cross-Sectional Studies; Early Detection of Cancer; Female; HIV Infections; Health Knowledge, Attitudes, Practice; Humans; Male; Mass Screening; Namibia; Papanicolaou Test; Surveys and Questionnaires; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35449007
DOI: 10.1186/s12905-022-01698-x -
Journal of Women's Health (2002) Aug 2022Pap smear has a central role in cervical cancer screening. Previous studies have found that female patients with disabilities are less likely to receive a Pap smear as...
Pap smear has a central role in cervical cancer screening. Previous studies have found that female patients with disabilities are less likely to receive a Pap smear as recommended by guidelines. The aim of our study was to examine the association between physical disability and Pap smear receipt in Israel. This cross-sectional study was conducted using the electronic medical records of the second largest health care maintenance organization in Israel. All female patients during 2012-2017 aged 25-65 were identified. The exposure variable was physical disability, and the outcome variable was Pap smear receipt. We used logistic regression to control for covariates. A total of 391,259 patients were eligible for this study, 6,720 (1.7%) with physical disability. 56.7% of patients with disabilities had received Pap smear compared to 63.3% of patients without disabilities, odds ratio (OR) 0.76, 95% confidence interval [CI] 0.72-0.80. When adjusting to sociodemographic and clinical covariates, patients with disabilities were less likely to receive Pap smear, adjusted OR 0.83, 95% CI 0.79-0.88. For all patients, older age, lower socioeconomic status, religious minorities, cardiovascular disease, type-2 diabetes mellitus, hypertension, smoking, and obesity were associated with lower odds of receipt of Pap smear. A history of nongynecologic oncologic disease was associated with increased odds of Pap smear receipt. Our study highlights the disparities between patients with and without physical disability with regard to screening for cervical cancer by receipt of Pap smear. Creating an appropriate practice with adequate access to patients with disability should be a focus for health care providers and policy makers.
Topics: Cross-Sectional Studies; Disabled Persons; Early Detection of Cancer; Female; Humans; Mass Screening; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35072543
DOI: 10.1089/jwh.2021.0447 -
Cancer Cytopathology Jun 2022
Topics: Artificial Intelligence; Female; Humans; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35291050
DOI: 10.1002/cncy.22561 -
BMJ Open Oct 2022There is a concern about performance of the screening approaches, where information on the quality of novel and affordable screening approaches that will perform well in...
Performance of HPV testing, Pap smear and VIA in women attending cervical cancer screening in Kilimanjaro region, Northern Tanzania: a cross-sectional study nested in a cohort.
OBJECTIVE
There is a concern about performance of the screening approaches, where information on the quality of novel and affordable screening approaches that will perform well in remote areas is warranted. This lack of information makes it difficult to prioritise resource use in efforts to improve cervical cancer outcomes. We aimed to compare the diagnostic value of human papillomavirus (HPV) testing on self-collected samples, Pap smear and visual inspection of the cervix with acetic acid (VIA) tests for detection of high-grade cervical intraepithelial neoplasia or worse (CIN2+).
DESIGN
A combined cross-sectional and cohort study.
SETTING
Three primary healthcare centres in Kilimanjaro region, Tanzania.
PARTICIPANTS
1620 women undergoing cervical cancer screening from December 2018 to September 2021. Inclusion criteria were being aged 25-60 years, and no history of premalignant or cervical cancer. Exclusion criteria were overt signs of cancer and previous hysterectomy.
INTERVENTIONS
Participants underwent HPV self-sampling with Evalyn Brush and Care HPV kit assay was used to determine prevalence of high-risk HPV infection. Women with positive HPV test were together with a random sample of HPV negative women scheduled for follow-up where VIA was performed, and Pap smear and cervical biopsies obtained.
RESULTS
Of 1620 women enrolled, 229 (14.1%) were HPV positive and 222 of these attended follow-up together with 290 (20.8%) women with negative HPV test. On VIA, 17.6% were positive. On Pap smear, 8.0% were classified as high-grade squamous intraepithelial lesion. The sensitivity and specificity, respectively, of the various tests, compared with histopathology for the detection of CIN2+ were: HPV test 62.5%, 59.3%; Pap smear 82.8%, 82.1% and; VIA 48.4%, 56.8%. When combined, the sensitivity and specificity for HPV and Pap smear were 90.6%, 70.6% while HPV and VIA were 65.6% and 75.5% for the detection of CIN2+.
CONCLUSIONS
The performance of care HPV testing on self-collected samples opens the possibility of increasing coverage and early detection in resource-constrained settings.
Topics: Female; Humans; Male; Papanicolaou Test; Uterine Cervical Neoplasms; Papillomaviridae; Cross-Sectional Studies; Alphapapillomavirus; Early Detection of Cancer; Papillomavirus Infections; Cohort Studies; Tanzania; Vaginal Smears; Mass Screening
PubMed: 36316070
DOI: 10.1136/bmjopen-2022-064321