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Computer Methods and Programs in... Oct 2018Early diagnosis and classification of a cancer type can help facilitate the subsequent clinical management of the patient. Cervical cancer ranks as the fourth most... (Review)
Review
BACKGROUND AND OBJECTIVE
Early diagnosis and classification of a cancer type can help facilitate the subsequent clinical management of the patient. Cervical cancer ranks as the fourth most prevalent cancer affecting women worldwide and its early detection provides the opportunity to help save life. To that end, automated diagnosis and classification of cervical cancer from pap-smear images has become a necessity as it enables accurate, reliable and timely analysis of the condition's progress. This paper presents an overview of the state of the art as articulated in prominent recent publications focusing on automated detection of cervical cancer from pap-smear images.
METHODS
The survey reviews publications on applications of image analysis and machine learning in automated diagnosis and classification of cervical cancer from pap-smear images spanning 15 years. The survey reviews 30 journal papers obtained electronically through four scientific databases (Google Scholar, Scopus, IEEE and Science Direct) searched using three sets of keywords: (1) segmentation, classification, cervical cancer; (2) medical imaging, machine learning, pap-smear; (3) automated system, classification, pap-smear.
RESULTS
Most of the existing algorithms facilitate an accuracy of nearly 93.78% on an open pap-smear data set, segmented using CHAMP digital image software. K-nearest-neighbors and support vector machines algorithms have been reported to be excellent classifiers for cervical images with accuracies of over 99.27% and 98.5% respectively when applied to a 2-class classification problem (normal or abnormal).
CONCLUSION
The reviewed papers indicate that there are still weaknesses in the available techniques that result in low accuracy of classification in some classes of cells. Moreover, most of the existing algorithms work either on single or on multiple cervical smear images. This accuracy can be increased by varying various parameters such as the features to be extracted, improvement in noise removal, using hybrid segmentation and classification techniques such of multi-level classifiers. Combining K-nearest-neighbors algorithm with other algorithm(s) such as support vector machines, pixel level classifications and including statistical shape models can also improve performance. Further, most of the developed classifiers are tested on accurately segmented images using commercially available software such as CHAMP software. There is thus a deficit of evidence that these algorithms will work in clinical settings found in developing countries (where 85% of cervical cancer incidences occur) that lack sufficient trained cytologists and the funds to buy the commercial segmentation software.
Topics: Algorithms; Diagnosis, Computer-Assisted; Early Detection of Cancer; Female; Humans; Image Interpretation, Computer-Assisted; Machine Learning; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 30195423
DOI: 10.1016/j.cmpb.2018.05.034 -
Revista Brasileira de Enfermagem 2016
Review
Topics: Female; Health Education; Humans; Papanicolaou Test; Patient Compliance; Uterine Cervical Neoplasms
PubMed: 27280579
DOI: 10.1590/0034-7167.2016690226i -
Arhiv Za Higijenu Rada I Toksikologiju Dec 2009
Topics: Chlamydia Infections; Female; Humans; Papanicolaou Test; Sensitivity and Specificity; Vaginal Smears
PubMed: 20061251
DOI: 10.2478/10004-1254-60-2009-2001 -
European Review For Medical and... Oct 2021Cervical cancer is largely preventable. Although routine Pap smear screening has reduced cervical cancer-related mortality by 70-80% in all countries and by... (Review)
Review
OBJECTIVE
Cervical cancer is largely preventable. Although routine Pap smear screening has reduced cervical cancer-related mortality by 70-80% in all countries and by approximately 90% in developing countries, the gynecologist is still confronted with women in advanced stages of the disease. The eradication of cervical cancer depends on identifying the disease early and removing barriers to its timely detection. Given the significant burden of cervical cancer in Asian countries, we investigated factors related to its screening in Asia.
MATERIALS AND METHODS
A comprehensive search was carried out in databases such as Medline, Web of Science and Scopus for articles published until September 2020. The following keywords were used: vaginal smear, Pap smear, cervical cancer screening, barriers, obstacles, challenge, early detection, the name of each Asian country, and a combination of these words.
RESULTS
Seventy-five articles were included in the study. The investigation revealed various factors related to cervical cancer screening in Asian women, including sociodemographic factors, awareness, attitudes and beliefs, perceived risk, psychological factors, self-efficacy, previous experiences, time, household, culture, fatalism, social support, access, cost, safety, insurance and health system-related factors.
CONCLUSIONS
Several barriers hinder the efficacy of a screening program. Its success requires the use of educational interventions, professional and inter-professional cooperation, allocation of sufficient resources, and policymakers focusing on the elimination of barriers.
Topics: Asian People; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 34661271
DOI: 10.26355/eurrev_202110_26889 -
The European Journal of Contraception &... Jun 2022Although the stressful psychological impact on women of an abnormal Pap smear is well documented, little research has been undertaken on its sexual impact. Our objective...
OBJECTIVE
Although the stressful psychological impact on women of an abnormal Pap smear is well documented, little research has been undertaken on its sexual impact. Our objective was to assess the impact of an abnormal Pap smear on the sexual function of affected women.
METHODS
A prospective study compared the sexual function of 48 women with an abnormal Pap smear (case group) with that of 48 women with a normal Pap smear (control group). Sexual function was assessed using the Female Sexual Function Index and the Hospital Anxiety Depression Scale. The questionnaires were mailed to the participants.
RESULTS
Surprisingly, the risk of sexual dysfunction was comparable between women with and without an abnormal Pap smear (odds ratio [OR] 0.7; = 0.4). The OR remained statistically non-significant after adjustment for risk factors. Multivariable analysis showed that only older age at first intercourse, depression and anxiety were identified as factors significantly associated with sexual dysfunction.
CONCLUSION
Contrary to our clinical experience, female sexual function is not impaired by an abnormal Pap smear. Further research is needed to better understand how sexuality in women with abnormal Pap smears may be affected.
Topics: Female; Humans; Papanicolaou Test; Prospective Studies; Surveys and Questionnaires; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35102804
DOI: 10.1080/13625187.2021.2012759 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2021The aim: The aim of this study was to determine the awareness level regarding pap smear in women living in Baghdad city, Iraq.
OBJECTIVE
The aim: The aim of this study was to determine the awareness level regarding pap smear in women living in Baghdad city, Iraq.
PATIENTS AND METHODS
Materials and methods: A cross-sectional study was done in 265 women living in Baghdad city using internet-based survey. Questionnaire was adopted from a previous study to measure the awareness level among women.
RESULTS
Results: the results showed that only 8(3%) of the respondent had a family history of cervical cancer. Almost (94%) have heard about cervical cancer, while only (38%) knew that HPV virus is the cause of cervical cancer. Majority of the respondents (87%) heard about pap smear while only 67 (25.0 %) had performed pap smear before. A total of 86% agreed that early diagnosis is important in treating of the cervical cancer.
CONCLUSION
Conclusions: Majority of women heard of cervical cancer and pap smear, but the level of its practice is still low with only 25% of respondents had performed it before. More health promotion is needed especially, at the primary care level regarding the importance of performing regular pap smear especially for women with family history of the cervical cancer.
Topics: Cross-Sectional Studies; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Iraq; Mass Screening; Papanicolaou Test; Surveys and Questionnaires; Uterine Cervical Neoplasms
PubMed: 34824173
DOI: No ID Found -
Journal of Transcultural Nursing :... Nov 2018Pap smear screening programs have been ineffective in reducing cervical cancer mortality in most Latin American and Caribbean countries, in part due to low screening... (Review)
Review
Social and Cultural Barriers to Women's Participation in Pap Smear Screening Programs in Low- and Middle-Income Latin American and Caribbean Countries: An Integrative Review.
PURPOSE
Pap smear screening programs have been ineffective in reducing cervical cancer mortality in most Latin American and Caribbean countries, in part due to low screening rates. The purpose of this review was to analyze recent studies to identify demographic, social, and cultural factors influencing women's participation in Pap screening programs in Latin America and the Caribbean.
DESIGN/METHOD
For this integrative review, cervical cancer screening in Latin America and the Caribbean was searched using PubMed, CINAHL, EMBASE, and PsycINFO databases. Findings/Results: Demographic barriers to screening were socioeconomic status, education, race/ethnicity, and geography. Social barriers included lack of uniformity in screening guidelines, lack of knowledge regarding cervical cancer, and lack of preventive culture. Cultural barriers were fear/embarrassment and gender roles.
CONCLUSIONS
There are multilevel barriers to Pap smear utilization among women in Latin America and the Caribbean.
IMPLICATIONS FOR PRACTICE
Findings highlight a need for health system engagement, promotion of preventive care, and community-generated educational programs and solutions.
Topics: Adult; Caribbean Region; Early Detection of Cancer; Female; Hispanic or Latino; Humans; Latin America; Mass Screening; Papanicolaou Test; Preventive Medicine; Uterine Cervical Neoplasms
PubMed: 29366369
DOI: 10.1177/1043659618755424 -
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 -
Journal of Community Health Dec 2019The purpose of this cross-sectional survey study was to explore common barriers to adequate Pap smear utilization among homeless women, and the factors that may relate...
The purpose of this cross-sectional survey study was to explore common barriers to adequate Pap smear utilization among homeless women, and the factors that may relate to cervical cancer testing in this population. Participants consisted of adult women recruited at a healthcare facility for the homeless. Data were collected through a self-completed questionnaire on knowledge, attitudes and intentions about Pap smears and cervical cancer. Analyses included descriptive and inferential statistics. Sixty participants who had experienced homelessness within the past year completed the study. The most frequently mentioned barrier to testing was not having enough time to obtain a Pap smear (n = 33; 55%). Linear regression found that there were no significant relationships between knowledge and attitudes about cervical cancer and intention to get a Pap smear. However, the study did find that women with a positive previous Pap smear experience had more positive attitudes about the process and outcomes of Pap smears (p = 0.011, p = 0.00, respectively). Participants with more knowledge about cervical cancer were less negative about Pap smear outcomes (p = 0.05), and that women with negative attitudes about Pap smear outcomes were less likely to have obtained a Pap smear in the past (p = 0.033). Interventions that promote positive attitudes about testing and outcomes, minimizing stress and inconvenience during the test, as well as increasing the ease of scheduling an appointment may help break down barriers to cervical cancer screening among homeless women.
Topics: Adult; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Ill-Housed Persons; Humans; New Mexico; Papanicolaou Test; Patient Acceptance of Health Care; Surveys and Questionnaires; Uterine Cervical Neoplasms
PubMed: 31313028
DOI: 10.1007/s10900-019-00704-y -
Asian Pacific Journal of Cancer... Oct 2020The aim of the study was to explore and describe perceptions of midwives on Papanicolaou (Pap smear) test during pregnancy.
PURPOSE
The aim of the study was to explore and describe perceptions of midwives on Papanicolaou (Pap smear) test during pregnancy.
METHODS
The study used qualitative, exploratory type of design. A probability purposive sampling was used to sample 12 registered midwives based in gynaecological units in a public hospital in Tshwane District, South Africa. Open-ended questionnaires, field notes, and audio tape were used to collect data. Data analysis process involved grouping and categorization into themes and sub-themes.
RESULTS
This study showed that majority of midwives lacked scientific knowledge behind Pap smear test during pregnancy. Some of the participants could relate with the test and verbalized that there may be complications such as bleeding, which may lead to miscarriage.
CONCLUSIONS
Findings showed that midwives were not performing Pap smear tests among pregnant women due lack of knowledge. This points out that Pap smear test is not prioritised as a secondary preventive tool at facility level. It is therefore recommended that refresher workshops be conducted at hospital level.
Topics: Adult; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Midwifery; Papanicolaou Test; Perception; Pregnancy; South Africa; Surveys and Questionnaires; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 33112565
DOI: 10.31557/APJCP.2020.21.10.3039