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Diagnostic Cytopathology Feb 2023In India, filariasis is a severe and significant public health problem. It has been reported to be present in any potential site. However, cervicovaginal Pap smear... (Review)
Review
In India, filariasis is a severe and significant public health problem. It has been reported to be present in any potential site. However, cervicovaginal Pap smear cytology rarely contains microfilariae despite the widespread occurrence. The occurrence of microfilariae in cervicovaginal smears has seldom been reported, even as an accidental finding. In our retrospective study, four cases of clinically asymptomatic filariasis were diagnosed on a routine cervicovaginal Pap smear from January 2019 to July 2022. All microfilariae were characterized as Wuchereria bancrofti. In the present study, the majority of the cases present vaginal discharge, and the diagnosis was made by cytopathology. Therefore, it is crucial to consider and look for microfilariae in areas where they are not endemic.
Topics: Animals; Female; Humans; Microfilariae; Parasites; Papanicolaou Test; Retrospective Studies; Filariasis
PubMed: 36269616
DOI: 10.1002/dc.25065 -
BMC Women's Health Aug 2021Cervical cancer is one of the most frequent types of cancer in females. The Pap smear is one of the most essential ways of diagnosing and screening for this malignancy,...
BACKGROUND
Cervical cancer is one of the most frequent types of cancer in females. The Pap smear is one of the most essential ways of diagnosing and screening for this malignancy, and any failure can be caused by a number of causes. The current study sought to investigate barriers to Pap smear in Iranian women.
METHOD
This qualitative content analysis study was conducted in Iran in 2019. Data was gathered through focus groups and individual semi-structured interviews with 32 women and health professionals. The interviewees were chosen using a combination of purposive and theoretical sampling. The data was then analyzed using the content analysis approach developed by Graneheim and Lundman. Guba and Lincoln's criteria for establishing trustworthiness were explored.
RESULTS
Data analysis resulted in the identification of four primary categories, seventeen subcategories, and 186 original concepts. The main categories include weakness of health system, difficult accessibility, low health literacy, and socio-cultural factors.
CONCLUSION
By informing women about the necessity and importance of Pap smear, providing the conditions, facilities, and equipment to facilitate the testing process, and paying more attention to cultural and social factors in cervical cancer and Pap smear planning, interventions, and policies, barriers to Pap testing can be eliminated.
Topics: Female; Health Knowledge, Attitudes, Practice; Humans; Iran; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 34362366
DOI: 10.1186/s12905-021-01428-9 -
Journal of Religion and Health Jun 2021This study aims to determine breast cancer fatalism in women and investigate the relationship between women's cervical cancer and pap smear test health beliefs with...
Determination of Breast Cancer Fatalism in Women and the Investigation of the Relationship Between Women's Cervical Cancer and Pap Smear Test Health Beliefs with Religious Orientation and Fatalism.
This study aims to determine breast cancer fatalism in women and investigate the relationship between women's cervical cancer and pap smear test health beliefs with religious orientation and fatalism. The study, which was conducted as a descriptive and relational screening one, was conducted in the eastern part of Turkey between July and August 2019. The study was conducted with 357 women who were not diagnosed with breast or cervical cancer, and who were not pregnant. A positive, significant relationship was found between the Religious Orientation Scale total mean score and Health Motivation and Pap smear Benefit Perception sub-scale mean score. A positive, significant relationship was found between the Fatalism Tendency Scale total mean score and Sensitivity, Importance Perception, Pap smear Benefit Perception and Pap smear Barrier Perception sub-scale mean scores (p < .05). The participating women were found to have a low level of breast cancer fatalism. Religious Orientation and Fatalism Tendency were found to have affected the Cervical Cancer and Pap Smear Test Health Beliefs. Similar studies are recommended to be conducted in larger groups and different regions.
Topics: Breast Neoplasms; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Motivation; Papanicolaou Test; Pregnancy; Turkey; Uterine Cervical Neoplasms
PubMed: 33123972
DOI: 10.1007/s10943-020-01108-2 -
BMC Women's Health Aug 2021Cervical cancer is considered treatable as long as it is detected early and managed effectively. Pap smear test is a screening tool that plays an important role in the...
OBJECTIVE
Cervical cancer is considered treatable as long as it is detected early and managed effectively. Pap smear test is a screening tool that plays an important role in the early detection, prevention and can prevent any early cervical cell changes from becoming cancer. This study aims to survey the effect of educational programs based on beliefs, subjective norms, and perceived behavior control on doing the pap-smear test in a sample of Iranian women.
MATERIALS AND METHODS
This experimental interventional study was performed on 300 women admitted to Fasa City, Fars Province, Iran health centers in 2018-2019. A questionnaire consisting of demographic information, knowledge, Health Belief Model, and Theory of Planned Behavior constructs were used to measure on doing of Pap smear test in women before and after 6 months' educational intervention.
RESULTS
The results revealed that 6 months after the intervention, 108 women (72%) in the experimental group and only 9 women (6%) in the control group received the Pap smear test.
CONCLUSIONS
The current research results revealed that education based on the combination of the health Belief model and theory of planned behavior might be promoting participation and an increasing rate of receiving Pap smear tests in women.
Topics: Behavior Control; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Iran; Papanicolaou Test
PubMed: 34362375
DOI: 10.1186/s12905-021-01419-w -
Women & Health Apr 2021Receiving a report of an abnormal finding of Pap screening test in women often leads to anxiety and depression. The purpose of this study was to investigate the...
Receiving a report of an abnormal finding of Pap screening test in women often leads to anxiety and depression. The purpose of this study was to investigate the construct validity and internal consistency reliability of the Serbian version of the Hospital Anxiety and Depression Scale (HADS) in women with abnormal Pap smear results. In 2017, a cross-sectional study was done involving 142 consecutive women attending cervical cancer screening who had received abnormal Pap smear results at one University clinical center in Serbia. We used exploratory factor analysis to establish the structure of the HADS and Cronbach's alpha coefficient was used for assessing the internal consistency. In our study, the HADS demonstrated high internal consistency, for both subscales (Cronbach's alpha coefficient for subscale Anxiety was 0.862, and for subscale Depression was 0.851). The intra-class correlation coefficients for the two components were significant (0.860 and 0.843, < .001). Principal component analysis with Oblimin rotation indicated a two-factor structure that explained 56.4% of variance. In conclusion, the Serbian version of the HADS showed satisfactory internal consistency reliability and construct validity and could be useful as a screening questionnaire for the assessment of anxiety and depression among women with abnormal Pap smear results.
Topics: Anxiety; Cross-Sectional Studies; Depression; Early Detection of Cancer; Female; Hospitals; Humans; Papanicolaou Test; Psychometrics; Reproducibility of Results; Serbia; Surveys and Questionnaires; Uterine Cervical Neoplasms
PubMed: 33641629
DOI: 10.1080/03630242.2021.1893244 -
Public Health Sep 2022To systematically appraise the existing published literature on cervical cancer screening utilization, and associated barriers and facilitators, in Nepal. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically appraise the existing published literature on cervical cancer screening utilization, and associated barriers and facilitators, in Nepal.
STUDY DESIGN
Systematic literature review and meta-analysis.
METHODS
PubMed/MEDLINE, CINAHL, Scopus, Embase, and, Google Scholar were systematically searched using Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. All quantitative and qualitative studies reporting cervical cancer screening (using the Pap smear test or visual inspection with acetic acid or human papillomavirus test) utilization, barriers, and facilitators for screening were identified. A meta-analysis was performed to estimate Nepal's pooled cervical cancer screening utilization proportion.
RESULTS
The search yielded 97 records, of which 17 studies were included. Fifteen studies were quantitative and two were qualitative. Of the 17 studies, six were hospital-based and six were community-based. The pooled cervical cancer screening utilization proportion (using Pap smear test) among Nepalese women was 17% from the studies in the hospital settings, and 16% in the community. Six studies reported barriers to cervical cancer screening, of which four reported embarrassments related to the gynecological examination and a low level of knowledge on cervical cancer. Three (of four) studies reported health personnel, and two studies reported screening services-related facilitators for cervical cancer screening.
CONCLUSION
Our review reported that cervical cancer screening utilization (16%) is more than four times lower than the national target (70%) in Nepal. Multiple barriers such as low levels of knowledge and embarrassment are associated with cervical cancer screening utilization. Health personnel's gender, counseling, and privacy of screening services were commonly reported facilitators. These findings could help to inform future research, and policy efforts to increase cervical cancer screening utilization in Nepal.
Topics: Early Detection of Cancer; Female; Humans; Mass Screening; Nepal; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35863158
DOI: 10.1016/j.puhe.2022.06.007 -
Joint Commission Journal on Quality and... Jul 2021Nonurgent clinically significant test results (CSTRs) are a common cause of missed and delayed diagnoses. However, little is known about the impact of electronic health...
INTRODUCTION
Nonurgent clinically significant test results (CSTRs) are a common cause of missed and delayed diagnoses. However, little is known about the impact of electronic health record (EHR) transitions on CSTR follow-up. This study examines follow-up rates for three CSTRs (incidental pulmonary nodules [IPNs]), prostate-specific antigen [PSA], and Pap smears) before and after EHR transition.
METHODS
This is a retrospective cohort study at an urban tertiary medical center using an interrupted time series (ITS) design to assess monthly changes in CSTR follow-up-defined as completion of computed tomography chest imaging 5 to 13 months after first mention of an IPN in a radiology report; completion of a follow-up PSA test, urology visit, or prostate biopsy within 6 months of the first reported PSA > 4; or completion of a colposcopy or gynecology visit within 6 months of a first reported abnormal Pap smear. Patients were included with first-onset abnormal CSTRs for IPN, PSAs > 4, or abnormal Pap smears occurring in the 24 months before and after the EHR transition.
RESULTS
There were no significant differences in follow-up in the IPN or the Pap smear ITS models. In the PSA ITS model, follow-up was significantly decreasing (p = 0.0133) in the preintervention period, and there was a significant change in trend from intervention to postintervention (p = 0.0279).
CONCLUSION
EHR transition reversed a decreasing trend over time for PSA test follow-up, while IPN and Pap smear follow-up trends did not change significantly. Effects of EHR transition may differ by test studied.
Topics: Electronic Health Records; Female; Follow-Up Studies; Humans; Male; Papanicolaou Test; Retrospective Studies; Vaginal Smears
PubMed: 33958289
DOI: 10.1016/j.jcjq.2021.03.010 -
BMJ Open Quality Jul 2023The incidence of cervical cancer has decreased by 70% since the 1950s. Preventative measures include vaccination against HPV strains and Papanicolaou tests. Early...
BACKGROUND
The incidence of cervical cancer has decreased by 70% since the 1950s. Preventative measures include vaccination against HPV strains and Papanicolaou tests. Early identification of cervical cancer through routine screening can significantly improve patient outcomes.
MATERIALS AND METHODS
At our academic institution, Community Internal Medicine (CIM) Clinic, 63% of female patients aged 21-65 were compliant with cervical cancer screening. The opening of the 'Saturday Pap Smear Clinic' sought to address barriers by offering non-traditional appointment times on Saturday mornings with an all female staff. Our aim was to increase the cervical cancer screening rate by 1% within 12 weeks. Our team compared CIM (intervention) and family medicine (FM) (control) compliance rates from September 2021 to January 2022. Messages were sent to the patient indicating non-compliance and offering options to complete screening.
RESULTS
At the start of this study, 5239 CIM patients were cervical cancer screening non-compliant. Postintervention, cervical screening rates among non-compliant women within CIM improved by 1.2%. The intervention cohort, CIM patients, had a significant improvement in compliance compared with the control group, FM patients. White women between the ages of 50 and 65 comprised the majority of patients who used the 'Saturday Pap Smear Clinic'.
CONCLUSIONS
The availability of Saturday appointments for cervical cancer screening completion can enhance cervical cancer screening compliance among eligible women. Eliminating barriers for women can improve health outcomes.
Topics: Female; Humans; Middle Aged; Aged; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears; Early Detection of Cancer; Appointments and Schedules
PubMed: 37451801
DOI: 10.1136/bmjoq-2023-002252 -
Journal of the American Society of... 2022Endocervical adenocarcinoma in situ (AIS) is not always identified on cervical Papanicolaou (Pap) test cytology because the Pap test has relatively low sensitivity for...
INTRODUCTION
Endocervical adenocarcinoma in situ (AIS) is not always identified on cervical Papanicolaou (Pap) test cytology because the Pap test has relatively low sensitivity for the diagnosis endocervical glandular lesions. We performed a retrospective study to determine the relative sensitivity of different diagnostic approaches, including Pap tests, cervical biopsy and/or endocervical curettage, loop electrosurgical excision procedure (LEEP), and hysterectomy specimens.
METHODS
Cases of endocervical AIS diagnosed from August 2005 to January 2019 were retrieved from our institution's pathology databases, and their clinicopathologic features were reviewed.
RESULTS
A total of 74 patients with endocervical AIS with or without concurrent squamous intraepithelial lesions or cervical neoplasms were identified. Their mean age at diagnosis was 39.9 years. More than one half of the cases of AIS were not detected from screening Pap tests but were diagnosed during histologic examination of cervical biopsy or endocervical curettage, LEEP, or cone biopsy specimens (~66%). Only a few patients had had a definitive diagnosis of AIS from the Pap tests (10.8%). Other abnormal glandular cytology included atypical glandular cells, not otherwise specified (16.2%), atypical glandular cells favoring neoplasia (5.4%), and atypical glandular cells suspicious for malignancy (1.3%). Abnormal squamous cytology was common in the study population (54%), with high-grade squamous intraepithelial lesion the most common finding (30%). AIS was diagnosed in 31 of 42 cervical biopsies or curettages, with 16 cases an incidental finding and 15 cases confirming previous abnormal glandular cytology. In addition, AIS was identified in 51 of 53 LEEPs. Approximately 41.5% of those undergoing LEEP had a previous diagnosis of AIS, and 54.7% of the cases were incidental findings. More than one half of the AIS cases harbored significant concurrent cervical lesions, including 26.7% with high-grade squamous intraepithelial lesion, 5.7% with low-grade squamous intraepithelial lesion, 1.9% with invasive squamous cell carcinoma, 20.9% with invasive adenocarcinoma, and 6.7% with microinvasive adenocarcinoma.
CONCLUSIONS
Our results have demonstrated that the ability to detect AIS with routine screening Pap testing or biopsy/curettage has variable efficacy depending on the screening methods. Given the relatively low combined sensitivity of Pap testing and biopsy/endocervical curettage in the diagnosis of AIS, all LEEPs and cervical cone biopsies performed for squamous cell abnormalities should be thoroughly evaluated for glandular lesions.
Topics: Adenocarcinoma in Situ; Adolescent; Adult; Aged; Biopsy; Cervix Uteri; Curettage; Female; Humans; Hysterectomy; Middle Aged; Papanicolaou Test; Retrospective Studies; Sensitivity and Specificity; Uterine Cervical Neoplasms; Young Adult
PubMed: 34509373
DOI: 10.1016/j.jasc.2021.08.002 -
BioMed Research International 2022Cervical cancer is a leading cause of mortality among women globally. Approaches to reduce cervical cancer incidence and mortality are "screen-and-treat," where positive...
BACKGROUND
Cervical cancer is a leading cause of mortality among women globally. Approaches to reduce cervical cancer incidence and mortality are "screen-and-treat," where positive primary test only is used in the treatment and "screen, triage and treat," where treatment is based on positive primary and triage tests with/without histological analysis.
OBJECTIVES
To determine cervical screening outcomes among HIV-infected and noninfected women using VIA, Pap smear, and HPV-PCR cervical screening methods and to determine the sensitivity, specificity, PPV and NPV of VIA, Pap smear, and HPV-PCR as primary test and sequential triage based on abnormal histopathology among HIV-infected and noninfected women. . This was a comparative cross-sectional study where women aged 18-46 years women underwent cervical screening and colposcopy-biopsy test as a positive-confirmatory test in the Referral Hospitals of Eastern Kenya.
RESULTS
A total of 317 (HIV negative: 156/317 (49.2%) and HIV positive: 161/317 (50.8%)) women were enrolled. Of these 81/317 (25.6%), 84/317 (26.5%), 96/317 (30.2%), and 78/122 (63.9%) participants had VIA, HPV DNA-PCR, Pap smear, and cervical histology positive results, respectively; average: 27.4% (HIV positive: 21.5%; HIV negative: 5.9%). Majority of women with LSIL [17/317 (5.4%)], HSIL [22/317 (6.9%)], invasive cancer [5/317 (1.6%)], cervicitis [45/317 (14.2%], and candidiasis 47/317 (14.8%) were HIV-infected ( < 0.001). 78/317 (24.6%) participants had positive histology test [ASCUS: 34/317 (10.7%) CIN1:17/317 (5.3%), CIN2: 16/317 (5.0%), CIN3:6/317 (1.9%), and ICC: 5/317 (1.6%)] ( > 0.001). A higher primary diagnostic accuracy was established by HPV DNA-PCR (sensitivity: 95.5%; specificity: 92.6%) than Pap smear and VIA test while in triage testing, high sensitivity was obtained by HPV DNA-PCR parallel testing with VIA test (92.6%) and Pap smear test (92.7%) and VIA cotesting with Pap smear (99.9%). HIV-infected women had increased specificity and reduced sensitivity and diagnostic accuracy by both primary and triage testing approaches. . Abnormal cervical screening outcome was high among HIV-infected than noninfected women. HIV-infected women had significantly high cases of cervical neoplastic changes. The diagnostic value of primary tests increased upon concurrent testing with other test methods hence reducing the number of women who would have been referred for biopsy.
CONCLUSION
High sensitivity and specificity in detection of CIN+ were established among HIV-infected than HIV noninfected women by HPV DNA-PCR and Pap smear than VIA test. HPV DNA-PCR test and Pap smear are more accurate in primary and sequential triage cervical screening based on abnormal histopathology outcomes among HIV-infected than noninfected women.
Topics: Cross-Sectional Studies; Early Detection of Cancer; Female; HIV Infections; Humans; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Sensitivity and Specificity; Triage; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 36164451
DOI: 10.1155/2022/1930102