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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 -
Diagnostic Cytopathology Jun 2018The development of the Papanicolaou smear test by Dr. George Nicholas Papanicolaou (1883-1962) is one of the most significant achievements in screening for disease and... (Review)
Review
The development of the Papanicolaou smear test by Dr. George Nicholas Papanicolaou (1883-1962) is one of the most significant achievements in screening for disease and cancer prevention in history. The Papanicolaou smear has been used for screening of cervical cancer since the 1950s. The test is technically straightforward and practical and based on a simple scientific observation: malignant cells have an aberrant nuclear morphology that can be distinguished from benign cells. Here, we review the scientific understanding that has been achieved and continues to be made on the causes and consequences of abnormal nuclear morphology, the basis of Dr. Papanicolaou's invention. The deformed nuclear shape is caused by the loss of lamina and nuclear envelope structural proteins. The consequences of a nuclear envelope defect include chromosomal numerical instability, altered chromatin organization and gene expression, and increased cell mobility because of a malleable nuclear envelope. HPV (Human Papilloma Virus) infection is recognized as the key etiology in the development of cervical cancer. Persistent HPV infection causes disruption of the nuclear lamina, which presents as a change in nuclear morphology detectable by a Papanicolaou smear. Thus, the causes and consequences of nuclear deformation are now linked to the mechanisms of viral carcinogenesis, and are still undergoing active investigation to reveal the details. Recently a statue was installed in front of the Papanicolaou's Cancer Research Building to honor the inventor. Remarkably, the invention nearly 60 years ago by Dr. Papanicolaou still exerts clinical impacts and inspires scientific inquiries.
Topics: Biomarkers, Tumor; Cell Nucleus; History, 20th Century; Humans; Neoplasms; Papanicolaou Test
PubMed: 29663734
DOI: 10.1002/dc.23941 -
PloS One 2021The knowledge of Pap smear and uptake of preventive behaviors to prevent cervical cancer are the most important contributors to the advanced stage of the disease....
BACKGROUND
The knowledge of Pap smear and uptake of preventive behaviors to prevent cervical cancer are the most important contributors to the advanced stage of the disease. Knowledge is one of the most leading factors to predict the health behaviors and a helpful factor in performing screening procedures. This study aimed to investigate Saudi Arabian women knowledge of Pap testing in relation to their intention to undergo the test.
METHODS
An online survey including demographic characteristics (3 questions), knowledge (13 questions), and intentions (3 questions) towards Pap smear was completed by 467 Saudi Arabian women. Data were analyzed through SPSS version 22, using descriptive statistics and correlation to measure the relationship between knowledge, demographic factors, and intention.
RESULTS
The study found that average level of knowledge was 1.3 which is between high and moderate knowledge, and the average score for the intention was 2.88, to indicate that the intentions to uptake Pap smear among the participants were above the average. The study revealed a significant correlation between demographic factors and intention (p<0.01).
CONCLUSION
Findings from the current study can inform health care providers about Saudi Arabian women knowledge of Pap smear and the intention to uptake the test. Strategies to motivate women to undergo Pap screening should be introduced.
Topics: Adolescent; Adult; Aged; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Middle Aged; Papanicolaou Test; Patient Acceptance of Health Care; Saudi Arabia; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult
PubMed: 34166452
DOI: 10.1371/journal.pone.0253850 -
Acta Cytologica 2014
Topics: Biopsy, Fine-Needle; Diffusion of Innovation; Female; Humans; Male; Molecular Diagnostic Techniques; Papanicolaou Test; Predictive Value of Tests; Vaginal Smears
PubMed: 25428030
DOI: 10.1159/000369593 -
CA: a Cancer Journal For Clinicians 1986
Topics: Adult; Female; Humans; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 3089548
DOI: 10.3322/canjclin.36.4.254-b -
Revista Gaucha de Enfermagem Mar 2016Objectives To identify socioeconomic and regional inequalities of pap smear coverage in the state of Rio Grande do Sul. Methods An ecological study based on data of the...
Objectives To identify socioeconomic and regional inequalities of pap smear coverage in the state of Rio Grande do Sul. Methods An ecological study based on data of the 2011-2012 national health information system to estimate the annual coverage of pap smears for the overall female population of the state and for women without private health insurance. We estimated annual pap smear coverage according to the Municipal Social Vulnerability Index and health macro-regions and regions of the state. Results The percentage of women without private health insurance ranged from 38.1% to 94.2% in the health regions. Pap smear coverage was 17.3% for the overall female population and 23.8% for women without private health insurance. Pap smear coverage was higher in more socially vulnerable municipalities and regions with a higher percentage of women with private health insurance. Conclusions The prevalence of private health insurance should be considered in studies that address the coverage of the Brazilian Unified Health System (SUS).
Topics: Adult; Brazil; Early Detection of Cancer; Female; Healthcare Disparities; Humans; Insurance Coverage; Insurance, Health; Middle Aged; Papanicolaou Test; Poverty Areas; Rural Population; Social Determinants of Health; Urban Population; Uterine Cervical Neoplasms; Vulnerable Populations
PubMed: 26982680
DOI: 10.1590/1983-1447.2016.01.52287 -
National Health Statistics Reports Jun 2021Background-Regular screening tests can lead to early detection of breast, cervical, and colorectal cancers, when treatment is likely to be more effective. This study...
Background-Regular screening tests can lead to early detection of breast, cervical, and colorectal cancers, when treatment is likely to be more effective. This study examines and compares sociodemographic, health status, and health behavior patterns of screening for breast cancer, cervical cancer, and colorectal cancer among women aged 45 and over in the United States. Methods-This study is based on data from the 2015 and 2018 National Health Interview Surveys. Women were considered to have received colorectal cancer screening if they reported having one of the following: a) report of a home fecal occult blood test (FOBT) in the past year, b) sigmoidoscopy procedure in the past 5 years with FOBT in the past 3 years, or c) colonoscopy in the past 10 years. Women were considered to have received breast cancer screening if they had a mammogram within the past 2 years. Women were considered to have received cervical cancer screening if they reported having a Pap smear in the past 3 years. Cancer screening was analyzed by sociodemographic, health status, health behavior, and health care use characteristics. Results-Among women aged 45 and over, higher percentages of screening were associated with higher socioeconomic status, being married or living with a partner, and healthy behaviors such as not smoking, participating in physical activity, and receiving a flu shot. Conclusion-Differences in screening identified in this study are generally consistent with previous studies on screening for colorectal, breast, and cervical cancers for women at average risk and within the age groups recommended for screening. The results of this study support other findings showing the persistence of disparities in cancer screening among women aged 45 and over according to most of the selected characteristics regardless of recommended age of screening.
Topics: Colorectal Neoplasms; Early Detection of Cancer; Female; Humans; Mammography; Papanicolaou Test; United States; Uterine Cervical Neoplasms
PubMed: 34181518
DOI: No ID Found -
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 -
The Yale Journal of Biology and Medicine Jun 2016Women comprise nearly one-quarter of all people living with human immunodeficiency virus (HIV) in the U.S. and 20 percent of incident annual cases. Though women overall... (Review)
Review
Women comprise nearly one-quarter of all people living with human immunodeficiency virus (HIV) in the U.S. and 20 percent of incident annual cases. Though women overall are more likely than men to be diagnosed with HIV and engage in care, they are as unlikely to successfully achieve viral suppression with antiretroviral therapy, suggesting gender-based disparities that should be addressed by gender-responsive policies and programs. Using the socioecological model of health and syndemics theory, we comprehensively reviewed published literature to evaluate reasons for and ways to address gender differences in HIV risk and treatment. We discuss the biologic, sociocultural, interpersonal, and behavioral contexts of HIV risk that affect women, comprehensive healthcare for women with HIV that includes pregnancy planning or prevention, and policy implications.
Topics: Female; HIV Infections; Humans; Papanicolaou Test; Women's Health
PubMed: 27354845
DOI: No ID Found -
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