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Journal of Population Therapeutics and... 2022Cervical cancer (CC) has a long preinvasive stage, which allows for preventive detection and possible cure. In this study, this stage was a target stage to investigate...
BACKGROUND AND OBJECTIVES
Cervical cancer (CC) has a long preinvasive stage, which allows for preventive detection and possible cure. In this study, this stage was a target stage to investigate women with precancerous lesions by applying the Papanicolaou (Pap) smear test and comduct performing a correlation study.s.
PATIENTS AND METHODS
A 2-year cross-sectional study was conducted, in which 200 married women (21-60 years old) participated in the investigation, which included women with Pap test abnormal results (atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesions (LSILs), and high-grade squamous intraepithelial lesions (HSILs)). These results were used to perform a polymerase chain reaction (PCR) test to detect the presence of human papillomavirus (HPV) of (6 and 11), a low-risk type, and (16 and 18), a high-risk type with colposcopy examination and colposcopy-guided biopsy, if needed for women with abnormal colposcopy outcomes. The treatment, per severity and disease stage, was applied.
RESULTS
The clinical presentation and Pap smear results of women enrolled in the study were as follows: 82.5% women were asymptomatic, postcoital bleeding (PCB) was seen in 17.0%, and intermenstrual bleeding was seen in a single case (0.5%). The history of sexually transmitted diseases was seen in 2.5% of the subjects. Pap smear results were as follows: no remarkable pathology was seen in 36.0%, inflammatory evidence was seen in 32.0%, ASCUS was seen in 19.0%, LSIL was seen in 7.5%, and HSIL was seen in 5.5% of the subjects. Regarding the HPV, the infection was negative in 95.0%, low-risk virus strains were seen in 1.5%, and high-risk viruses were seen in 3.5%. Low-risk HPV included 6, 11, and 42, whereas the high-risk group included five cases of HPV16 and two cases of HPV 18.
CONCLUSIONS
The present work presents the Pap smear test as a highly useful, easy, technically safe, and cost-effective tool for detecting cervical epithelial precancerous lesions, which can be used as a routine screening technique for better treatment outcomes and reducing mortality rates. The power of detection of these lesions can be potentiated when using the Pap test and HPV-PCR test together.
Topics: Adult; Atypical Squamous Cells of the Cervix; Cross-Sectional Studies; DNA, Viral; Early Detection of Cancer; Female; Humans; Male; Middle Aged; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Sensitivity and Specificity; Uterine Cervical Neoplasms; Young Adult; Uterine Cervical Dysplasia
PubMed: 35686892
DOI: 10.47750/jptcp.2022.892 -
Cancer NursingBlack women face cervical cancer disparities with higher rates of morbidity and mortality compared with White women. Identifying predictors of Papanicolaou (Pap) testing...
BACKGROUND
Black women face cervical cancer disparities with higher rates of morbidity and mortality compared with White women. Identifying predictors of Papanicolaou (Pap) testing is a first step to decrease morbidity and mortality from cervical cancer, with barriers and self-efficacy being constructs that should be related to Pap testing adherence. Although barriers and self-efficacy scales have been developed, they have not been validated in Black women for Pap testing.
OBJECTIVE
The purpose of this study was to modify and psychometrically test barriers and self-efficacy to Pap testing in a Black population.
INTERVENTION/METHODS
Data were collected from a minority health fair. Internal consistency reliability testing was conducted using item analysis and Cronbach's α. Construct validity was assessed by exploratory factor analysis and logistic regression. Papanicolaou testing adherence was regressed on each scale (barriers and self-efficacy) while controlling for antecedents.
RESULTS
Data demonstrated 2 reliable scales: (1) barriers (Cronbach's α = .79), item-total correlation = 0.479 to 0.628; and (2) self-efficacy (Cronbach's α = .85), item-total correlation = 0.560 to 0.697. Exploratory factor analysis supported 2 unidimensional scales. The regression models supported a relationship between each scale and Pap testing adherence.
CONCLUSIONS
The data suggested barriers and self-efficacy scales were reliable and valid among Black women. Barriers and self-efficacy could be tailored in future interventions to increase Pap testing adherence.
IMPLICATIONS FOR PRACTICE
Nurses could use responses to these scales for framing discussions about Pap testing.
Topics: Female; Humans; Papanicolaou Test; Psychometrics; Reproducibility of Results; Self Efficacy; Surveys and Questionnaires; Vaginal Smears
PubMed: 32976184
DOI: 10.1097/NCC.0000000000000879 -
BMC Women's Health Feb 2022Nigeria has a low uptake of cervical cancer screening and is one of the five countries that represent over half of the global burden of deaths from cervical cancer....
INTRODUCTION
Nigeria has a low uptake of cervical cancer screening and is one of the five countries that represent over half of the global burden of deaths from cervical cancer. Social marketing principles can be used to design and implement interventions to increase uptake of cervical cancer screening. This study assessed the effect of a social marketing intervention on the knowledge, attitude, and uptake of pap smear among women residing in an urban slum in Lagos State, Nigeria.
MATERIALS AND METHODS
This was a quasi-experimental study. The intervention arm consisted of 140 women recruited from Ago-Egun Bariga community and the control arm consisted of 175 women recruited from Oto-Ilogbo extension community. Social marketing intervention was instituted in the intervention group. Data analysis was done using IBM SPSS Statistics version 20 and Stata version 16.0. Between groups comparisons and within groups comparisons were done using bivariate analysis with Chisquare, Students t test and Paired t test as appropriate.
RESULTS
In both the intervention and control groups, the mean knowledge score of cervical cancer was low at baseline (0.0 ± 0.3 and 0.1 ± 0.9 respectively). In the intervention group, there was a significant increase in mean knowledge score to 15.1 ± 3.7, post-intervention (p < 0.001). In both groups, the mean attitude score of cervical cancer was low at baseline (27.1 ± 0.8 in the intervention group and 27.2 ± 1.4 in the control group). In the intervention group, there was a significant increase in mean attitude score to 36.5 ± 4.8, post-intervention (p < 0.001). In both the intervention and control groups, uptake of pap smear was low at baseline (0.0% and 0.6%, respectively). In the intervention group, there was a significant increase in uptake of pap smear to 84.3%, post-intervention (p < 0.001). There was no statistically significant change in knowledge, attitude or uptake of pap smear in the control group, post-intervention.
CONCLUSION
This study demonstrated that social marketing intervention can be successful in improving knowledge, attitude, and also the uptake of pap smear, even in settings where these are abysmally low. It is recommended that social marketing intervention be employed as a strategy for improving cervical cancer screening among women residing in slums.
Topics: Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Nigeria; Papanicolaou Test; Poverty Areas; Social Marketing; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35164717
DOI: 10.1186/s12905-022-01620-5 -
Journal of Immigrant and Minority Health Oct 2020As refugee populations continue to age in the United States, there is a need to prioritize screening for chronic illnesses, including cancer, and to characterize how... (Review)
Review
As refugee populations continue to age in the United States, there is a need to prioritize screening for chronic illnesses, including cancer, and to characterize how social and cultural contexts influence beliefs about cancer and screening behaviors. This study examines screening rates and socio-cultural factors influencing screening among resettled refugee women from Muslim-majority countries of origin. A systematic and integrative review approach was used to examine articles published from 1980 to 2019, using PubMed, CINAHL, and PsycINFO. A total of 20 articles met the inclusion criteria. Cancer screening rates among refugee women are lower when compared to US-born counterparts. Social and cultural factors include religious beliefs about cancer, stigma, modesty and gender roles within the family context. The findings of this review, suggest that resettled refugee women underutilize preventive services, specifically mammography, Pap test and colonoscopy screening, and whose perceptions and behaviors about cancer and screening are influenced by social and cultural factors.
Topics: Early Detection of Cancer; Female; Humans; Islam; Mass Screening; Neoplasms; Papanicolaou Test; Refugees; United States
PubMed: 31900753
DOI: 10.1007/s10903-019-00967-6 -
BMC Women's Health Dec 2022Despite the national cervical cancer (CC) screening program established in 2006, the CC incidence in Estonia in 2020 was still one of the highest in Europe. To better...
BACKGROUND
Despite the national cervical cancer (CC) screening program established in 2006, the CC incidence in Estonia in 2020 was still one of the highest in Europe. To better understand the possible barriers among women, the aim of this study was to describe the inequalities in the Pap smear uptake trend in 2004-2020 and to analyse the associations between different factors in Estonia.
METHODS
Weighted data of 25-64-year-old women (N = 6685) from population-based cross-sectional studies of Health Behaviour among Estonian Adult Population in 2004-2020 was used. Linear trends in uptake of Pap smear over time were tested using the Cochrane-Armitage test. Binary logistic regression with interactions was performed to analyse associations between the uptake of Pap smear and sociodemographic, socioeconomic, health-related and lifestyle factors. Crude and adjusted odds ratios with 95% confidence intervals were calculated.
RESULTS
Prevalence of lifetime uptake of Pap smear increased in 2004-2020 from 50.6 to 86.7% (P < 0.001). From 2004 to 2020, uptake of Pap smear increased significantly among women aged 25-34, 35-44, 45-54 and 55-64, in both ethnicity groups and among women with basic, secondary and higher education (P < 0.001). The gap in Pap smear uptake increased between Estonians and non-Estonians but decreased between education levels over time. Lower lifetime uptake of Pap smear was associated from sociodemographic factors with younger age, being non-Estonian and single, from socioeconomic factors with lower educational level and unemployment, from health indicators with higher body mass index indicating overweight and obesity, presence of chronic disease and depressiveness, and from lifestyle factors with non-smoking.
CONCLUSIONS
Although Pap smear uptake among 25-64 year old women increased significantly in Estonia in 2004-2020, inequalities were found indicating an opportunity for development of targeted CC prevention strategies.
Topics: Adult; Female; Humans; Middle Aged; Uterine Cervical Neoplasms; Vaginal Smears; Cross-Sectional Studies; Early Detection of Cancer; Mass Screening; Papanicolaou Test; Health Knowledge, Attitudes, Practice
PubMed: 36566176
DOI: 10.1186/s12905-022-02123-z -
BMC Women's Health Jul 2023In 2020, cervical cancer ranked fourth in terms of both frequency of diagnosis and the leading cause of cancer-related deaths among women globally. Among Malaysian...
BACKGROUND
In 2020, cervical cancer ranked fourth in terms of both frequency of diagnosis and the leading cause of cancer-related deaths among women globally. Among Malaysian women, it was the third most prevalent form of cancer. Published data on nationally representative cervical cancer screening in Malaysia have been limited. Therefore, this study aimed to determine the prevalence of receiving a Pap smear test in the past three years, its relationship with socio-demographic factors and physical activity.
METHODS
Using a subset of survey data from the National Health and Morbidity Survey (NHMS) 2019, a secondary data analysis was performed. Trained research assistants collected data through face-to-face method using a mobile tablet questionnaire system application. Logistic regression analysis was performed to examine the relationship between sociodemographic factors, physical activity, and cervical cancer screening. The analyses were conducted using STATA version 14 (Stata Corp, College Station, Texas, USA), accounting for sample weighs and complex sampling design.
RESULTS
The analysis included 5,650 female respondents, representing an estimated 10.3 million Malaysian female adults aged 18 and above. Overall, 35.2% (95%CI 33.2, 37.4) respondents had a Pap smear test within the past three years. Respondents who were physically active were 1.41 times more likely to have a Pap smear test. Similarly, respondents aged 35-59 (OR 1.84; 95%CI 1.46, 2.34) and those living in rural localities (OR 1.38; 95%CI 1.13, 1.70) had higher odds of receiving a Pap smear test. Compared to married respondents, single respondents (OR 0.04; 95%CI 0.02, 0.07) and widowed/divorcee respondents (OR 0.72; 95%CI 0.56, 0.82) were less likely to receive a Pap smear test. Educated respondents were more likely to have had a Pap smear test.
CONCLUSIONS
The overall prevalence of cervical cancer screening in Malaysia remains low (35.2%). Efforts should be made to strengthen health promotion programs and policies in increasing awareness on the significance of cervical cancer screening. These initiatives should specifically target younger women, single women, and widowed/divorced individuals. The higher cervical screening uptake among rural women should be studied further, and the enabling factors in the rural setup should be emulated in urban areas whenever possible.
Topics: Adult; Female; Humans; Vaginal Smears; Uterine Cervical Neoplasms; Early Detection of Cancer; Malaysia; Prevalence; Mass Screening; Papanicolaou Test; Surveys and Questionnaires; Health Knowledge, Attitudes, Practice
PubMed: 37491253
DOI: 10.1186/s12905-023-02553-3 -
Journal of Psychosomatic Obstetrics and... Mar 2020Abnormal Pap smear result means there have been cell changes on the cervix but are not cancer. Women with abnormal test result may be affected from this situation. What...
Abnormal Pap smear result means there have been cell changes on the cervix but are not cancer. Women with abnormal test result may be affected from this situation. What do women with abnormal Pap smear results experience from a biopsychosocial perspective? This study aimed to explore the experiences of women with abnormal Pap smear results according to the biopsychosocial model. This phenomenological study's data were collected in interviews with 12 women who had abnormal Pap smear test results. Data collection tool consists of two parts that are an "Women's Information Form (WIF)" identifying women and semi-structured "Interview Form". Interviews were done face-to-face by using in-depth interviews technique. Semi-structured interview was recorded in audio recording device. Thematic approach was used to assess the data. The average age of the women was 42.5 ± 3.64, their age at first sexual intercourse was 23.0 ± 2.8 years and all of them were legally married. Five main themes were determined, which were grouped under the Biopsychosocial Model Domains. The Biological Domain themes were Perception of Health and Disease, and Cervical Cancer Risk Factors; the Psychological Domain themes were Positive Feelings and Negative Feelings; the Social Domain theme was Continuing Social Life. It was concluded that the cultural beliefs, perceptions, emotions and practices of women with abnormal Pap smear results should be considered in the diagnostic and treatment processes. These characteristics of women's experience are also important to consider when developing strategies to address barriers to effective cervical screening, diagnosis and treatment.
Topics: Adult; Culture; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Models, Biopsychosocial; Papanicolaou Test; Qualitative Research; Social Perception; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 31452433
DOI: 10.1080/0167482X.2019.1657090 -
Cytopathology : Official Journal of the... Mar 2022Implementation of quality control measures ensures acceptable performance by a laboratory. This study aims to assess the quality of cervical cytopathology reporting...
OBJECTIVES
Implementation of quality control measures ensures acceptable performance by a laboratory. This study aims to assess the quality of cervical cytopathology reporting using quality metrics like atypical squamous cells (which include both atypical squamous cells of undetermined significance and atypical squamous cell -cannot rule out high grade squamous intraepithelial lesion)/squamous intraepithelial lesion (ASC/SIL), cytohistological correlation (CHC) and positive predictive value (PPV) of Papanicolaou (Pap) smears for squamous lesions of cervix.
METHODS
A retrospective study of Pap smears from 2015 to 2020 was performed. The quality metrics analysed include diagnoses of ASCUS, ASC-H and ASCUS/SIL ratio, CHC and PPV. Cases with cervical biopsies/hysterectomy were included for CHC, and discrepancy was defined as discordance in diagnostic category between cytology and histology in the CHC.
RESULTS
A total of 22,695 cervical cytology smears were reported. Unsatisfactory smears (n = 290) were excluded. Squamous lesions were reported in 233 smears, and the Bethesda system of nomenclature was followed. A definitive diagnosis (SILs and SCC) was given in 74% of cases. ASCUS and ASC-H were reported in 47 and 14 cases, respectively. The most common lesion on Pap smear was high-grade squamous intraepithelial lesion (HSIL; n = 92), followed by low-grade squamous intraepithelial lesion (LSIL; n = 64), and two were ungradable SIL. Squamous cell carcinoma (SCC) was reported in 14 smears. The ASC/SIL ratio was 0.38. CHC (n = 139) was 100% for ASC-H, LSIL, SCC and 84.7% for HSIL. A review of discrepant cases suggested sampling and interpretational discrepancy in five and one cases, respectively. The PPV of Pap smear for squamous lesions was 96.4%.
CONCLUSION
It is essential to have good quality cytopathology reports for early identification, which enables appropriate management. The most commonly used quality indicator for cytopathology is the ASCUS/SIL ratio. This study suggests the inclusion of the CHC and PPV values as quality metrics for Pap smear, since these are easily measurable and serve as a good indicator of quality in cervical cytopathology reporting.
Topics: Benchmarking; Cervix Uteri; Female; Humans; Papanicolaou Test; Retrospective Studies; Uterine Cervical Neoplasms; Vaginal Smears; Uterine Cervical Dysplasia
PubMed: 34854153
DOI: 10.1111/cyt.13082 -
Mathematical Biosciences and... Apr 2022Cervical 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 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. Due to this reason Artificial intelligence (AI) based computer-aided diagnosis system for the classification 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, the deep learning-based hybrid methodology namely DeepCyto is proposed for the classification of pap smear cytology images. The DeepCyto extracts the feature fusion vectors from pre-trained models and passes these to two workflows. Workflow-1 applies principal component analysis and machine learning ensemble to classify the pap smear images. Workflow-2 takes feature fusion vectors as an input and applies an artificial neural network for classification. The experiments are performed on three benchmark datasets namely Herlev, SipakMed, and LBCs. The performance measures of accuracy, precision, recall and F1-score are used to evaluate the effectiveness of the DeepCyto. The experimental results depict that Workflow-2 has given the best performance on all three datasets even with a smaller number of epochs. Also, the performance of the DeepCyto Workflow 2 on multi-cell images of LBCs is better compared to single cell images of other datasets. Thus, DeepCyto is an efficient method for accurate feature extraction as well as pap smear image classification.
Topics: Artificial Intelligence; Cervix Uteri; Female; Humans; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35730264
DOI: 10.3934/mbe.2022301 -
Anticancer Research Jan 2022Ovarian cancer (OC) has the poorest prognosis and the highest mortality rate among gynecological malignancies, which is largely due to delayed diagnosis. Therefore, an... (Review)
Review
Ovarian cancer (OC) has the poorest prognosis and the highest mortality rate among gynecological malignancies, which is largely due to delayed diagnosis. Therefore, an effective detection strategy is a compelling need. Here, we review the potential use of cervical cell swabs (Pap specimens, liquid) for early detection of OC. It has been shown, that malignant cells exfoliate from the ovaries and may be detected in Pap specimens, routinely collected through cervical cancer screening. Using Medical Subject Headings (MeSH) for searching the PubMed database we identified eight studies reporting the use of Pap specimen in early detection of OC. Six focused on detection of gene mutations, using gene panels or analysis of TP53 variants. Two studies reported analysis of methylation profiles. Seven studies were published in 2018 or later. Additionally, we found one study without MeSH terms assigned yet, which postulated using peptide biomarkers present in Pap-test fluid. In this review we present their main findings, discuss challenges this approach presents and include ideas for improved detection.
Topics: Early Detection of Cancer; Female; Humans; Ovarian Neoplasms; Papanicolaou Test; Vaginal Smears
PubMed: 34969703
DOI: 10.21873/anticanres.15451