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Journal of Medical Screening Jun 2021Breast and cervical cancers are screen-detectable; yet, challenges exist with ensuring uptake of mammography and Pap smear. Family, a central factor in developing... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Breast and cervical cancers are screen-detectable; yet, challenges exist with ensuring uptake of mammography and Pap smear. Family, a central factor in developing knowledge to carry out health promotion behaviors, may be an asset to improving intention to screen among non-adherent women from underrepresented minority groups. We explored familial cancer; communication; and breast and cervical screening intention among non-adherent Black, Latina, and Arab women in the United States who participated in a randomized controlled trial of the Kin Keeper Cancer Prevention Intervention study. The intervention was a culturally-targeted breast and cervical cancer literacy tool for Black, Latina, and Arab women, consisting of two family-focused education sessions on the cancers, their screening guidelines, and risk-reducing health-related behaviors.
METHODS
For this secondary analysis, we assessed family cancer history, family communication, and screening intention for breast and cervical cancer in age-eligible, non-adherent participants. Descriptive statistics examined sample characteristics of the intervention and control groups. Odds ratios were estimated from logistic regression modeling to assess the intervention and sample characteristic effects on screening intention.
RESULTS
Of the 516 participants, 123 and 98 were non-adherent to breast and cervical cancer screening, respectively. The intervention (OR = 1.95 for mammography; OR = 1.62 for Pap smear) and highly communicative (OR = 2.57 for mammography; OR = 3.68 for Pap smear) families reported greater screening intention. Family history of cancer only increased screening intention for mammography (OR = 2.25).
CONCLUSION
Family-focused approaches supporting communication may increase breast and cervical cancer screening intention among non-adherent, underrepresented minority groups.
Topics: Breast Neoplasms; Communication; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Intention; Mammography; Mass Screening; Papanicolaou Test; United States; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 32393152
DOI: 10.1177/0969141320920900 -
Modern Pathology : An Official Journal... Jul 2004Our purpose was to determine the reliability of the Pap smear in making the diagnosis of bacterial vaginosis and to examine the characteristics of Pap smear vs vaginal... (Comparative Study)
Comparative Study
Our purpose was to determine the reliability of the Pap smear in making the diagnosis of bacterial vaginosis and to examine the characteristics of Pap smear vs vaginal culture in diagnosis of bacterial vaginosis, with the vaginal Gram stain used as the diagnostic standard. We performed a prospective, blinded study involving 245 women who referred to the Department of Gynecology and Obstetrics in our hospital for routine genital examination between September 2001 and September 2002. Exclusion criteria included vaginal bleeding and pregnancy. Each patient had standard Pap smear, Gram-stained vaginal smear and culture of vaginal swab. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic value of Pap smear and vaginal culture results were determined with Gram stain used as the standard for diagnosis of bacterial vaginosis. Using Gram stain diagnosis of bacterial vaginosis as the standard, Pap smear and vaginal culture test results had sensitivity of 43.1 and 77.8%, specificity of 93.6 and 97.7%, positive predictive value of 73.8 and 93.3%, negative predictive value of 79.8 and 91.4%, diagnostic value of 78.8 and 91.8%, respectively, for the diagnosis of bacterial vaginosis. Compared to the microbiological test results, Pap smear is not sensitive enough for screening of bacterial vaginosis. However, because of its high specificity, it may be an adequate diagnostic criteria when it is positive.
Topics: Adolescent; Adult; Aged; Bacterial Infections; Bacteriological Techniques; Bacteroides; Female; Gardnerella vaginalis; Gentian Violet; Humans; Lactobacillus; Middle Aged; Papanicolaou Test; Phenazines; Prospective Studies; Reproducibility of Results; Sensitivity and Specificity; Single-Blind Method; Vaginal Smears; Vaginosis, Bacterial
PubMed: 15073605
DOI: 10.1038/modpathol.3800132 -
Scientific Reports May 2019Recent research on vaginal microbiota relies on high throughput sequencing while microscopic methods have a long history in clinical use. We investigated the...
Recent research on vaginal microbiota relies on high throughput sequencing while microscopic methods have a long history in clinical use. We investigated the correspondence between microscopic findings of Pap smears and the vaginal microbiota composition determined by next generation sequencing among 50 asymptomatic women. Both methods produced coherent results regarding the distinction between Lactobacillus-dominant versus mixed microbiota, reassuring gynaecologists for the use of Pap smear or wet mount microscopy for rapid evaluation of vaginal bacteria as part of diagnosis. Cytologic findings identified women with bacterial vaginosis and revealed that cytolysis of vaginal epithelial cells is associated to Lactobacillus crispatus-dominated microbiota. Education and socio-economic status were associated to the vaginal microbiota variation. Our results highlight the importance of including socio-economic status as a co-factor in future vaginal microbiota studies.
Topics: Adult; Bacteria; Epithelial Cells; Female; Finland; Gardnerella vaginalis; High-Throughput Nucleotide Sequencing; Humans; Lactobacillus; Microbiota; Microscopy; Papanicolaou Test; RNA, Ribosomal, 16S; Reproducibility of Results; Social Class; Vagina; Vaginal Smears; Vaginosis, Bacterial
PubMed: 31123296
DOI: 10.1038/s41598-019-44157-8 -
Asian Pacific Journal of Cancer... 2012Cervical cancer is an important woman's health problems worldwide, especially in low socio-economic countries. The aim of this study was to compare the Pap smear... (Comparative Study)
Comparative Study
Cervical cancer is an important woman's health problems worldwide, especially in low socio-economic countries. The aim of this study was to compare the Pap smear screening results between Akha hill tribe and urban women who live in Chiang Rai province, Thailand. Screening was conducted for 1,100 Akha women and 1,100 urban women who came to have the Pap smear at Chiangrai Prachanukroh Hospital and 1 private cytology laboratory from January to June 2008. The demographic characteristics and factors related to abnormal Pap smears of these women were gathered using closed model questionnaires. Abnormal Rap smears were defined according to the Bethesda 2001 system. The results showed that the prevalence of abnormal Pap smears was 12.2% in Akha women and 4.5% in urban women. The highest prevalence of Pap abnormalities was found in the 41-50 years age group in both populations (4.5% in Akha and 1.7% in urban women). In both populations, abnormal Pap smears were found in <21 years age groups. From the questionnaires, the possible risk factors related to the higher prevalence of abnormal Pap smears in Akha women were early age at marriage (≤17 years), high frequency pregnacies and high parity and no/low education level. In conclusion, cervical cancer control by education and early detection by Pap smear screening is necessary for hill tribe women. More Pap smear screening service units should be set to improve the coverage for the risk group women who got married in young age, especial in ethnic groups.
Topics: Adult; Ethnicity; Female; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Middle Aged; Papanicolaou Test; Risk Factors; Rural Population; Thailand; Urban Population; Uterine Cervical Neoplasms; Vaginal Smears; Women's Health; Young Adult
PubMed: 23317207
DOI: 10.7314/apjcp.2012.13.11.5501 -
BMC Family Practice Aug 2019In France, with the growing scarcity of gynecologists and a globally low and socially differentiated coverage of cervical cancer screening (CCS), general practitioners...
General practitioners who never perform Pap smear: the medical offer and the socio-economic context around their office could limit their involvement in cervical cancer screening.
BACKGROUND
In France, with the growing scarcity of gynecologists and a globally low and socially differentiated coverage of cervical cancer screening (CCS), general practitioners (GPs) are valuable resources to improve screening services for women. Still all GPs do not perform Pap smears. In order to promote this screening among GPs, the characteristics of physicians who never perform CCS should be more precisely specified. Besides already-known individual characteristics, the contextual aspects of the physicians' office, such as gynecologist density in the area, could shape GPs gynecological activities.
METHODS
To analyze county (département) characteristics of GPs' office associated with no performance of CCS, we used a representative sample of 1063 French GPs conducted in 2009 and we constructed mixed models with two levels, GP and county.
RESULTS
Almost 35% (n = 369) of the GPs declared never performing CCS. GPs working in counties with a poor GP-density per inhabitants were more likely to perform CCS (odds ratio (OR) = 0.52 for each increase of density by 1 GP per 10,000 inhabitants, 95% confidence interval (CI) = 0.37-0.74). On the contrary, GPs working in counties with an easier access to a gynecologist were more likely not to perform CCS (OR = 1.06 for each increase of density by 1 gynecologist per 100,000 women, 95%CI = 1.03-1.10 and OR = 2.02 if the first gynecologist is reachable in less than 15 min, 95%CI = 1.20-3.41) as well as GPs working in areas with a poverty rate above the national average (OR = 1.66, 95%CI = 1.09-2.54). These contextual characteristics explain most of the differences between counties concerning rates of not performing CCS.
CONCLUSIONS
Specific programs should be developed for GPs working in contexts unfavorable to their involvement in CCS.
Topics: Adult; Early Detection of Cancer; Female; France; General Practitioners; Humans; Male; Middle Aged; Papanicolaou Test; Practice Patterns, Physicians'; Socioeconomic Factors; Uterine Cervical Neoplasms
PubMed: 31416425
DOI: 10.1186/s12875-019-1004-x -
Journal of Gynecologic Oncology May 2024This study aims to investigate the implementation rate and influencing factors of confirmatory tests for women with abnormal cervical cytology results in the Korean...
OBJECTIVE
This study aims to investigate the implementation rate and influencing factors of confirmatory tests for women with abnormal cervical cytology results in the Korean nationwide cervical cancer screening program.
METHODS
The National Health Insurance Service (NHIS) database was utilized to identify all Korean women who have participated in the Korean nationwide cervical cancer screening program from January 2011 and December 2021 using the NHIS database. Multiple logistic regression analysis was performed to estimate the multivariate odds ratio and evaluate the patients' characteristics.
RESULTS
The rate of abnormal Papanicolaou (Pap) smears showed an initial increase from 2011 to 2015 and subsequently reached a plateau after 2016. When examining specific subcategories, cases of atypical squamous cells of undetermined significance (ASC-US) increased from 28,546 cases (1.1%) in 2011 to 62,850 cases (1.7%) in 2021. In contrast, cases of HSIL and SCC declined from 3,535 cases (0.14%) to 2,763 cases (0.07%) and from 383 cases (0.01%) to 179 cases (0.005%), respectively. Furthermore, the implementation rate of confirmatory tests for women with abnormal cytology increased from 8,865 cases (21.0%) in 2011 to 39,045 cases (51.2%) in 2021. Regarding the specific subcategory of ASC-US, the number of confirmatory tests exhibited a substantial increase from 4,101 cases (14.4%) in 2011 to 30,482 cases (48.5%) in 2021. For SCC, there was no significant change, with 216 cases (56.4%) in 2011 and 102 cases (57.0%) in 2021. The implementation rate of confirmatory tests was found to be significantly associated with results of abnormal Pap smear, age, and residence. Notably, economic status did not emerge as a significant factor affecting the likelihood of undergoing confirmatory tests.
CONCLUSIONS
The severity of abnormal Pap smear results is a reliable indicator of the probability of undergoing a confirmatory test. Additional endeavors are required to improve the implementation rate among women who have received abnormal Pap smear results.
Topics: Humans; Female; Papanicolaou Test; Adult; Uterine Cervical Neoplasms; Middle Aged; Republic of Korea; National Health Programs; Early Detection of Cancer; Vaginal Smears; Aged; Atypical Squamous Cells of the Cervix; Databases, Factual; Young Adult; Uterine Cervical Dysplasia
PubMed: 38130135
DOI: 10.3802/jgo.2024.35.e26 -
BMJ Open Jan 2024Although Pap smear (PS) is considered the best standard in detecting cervical cancer, adherence to timely and regular PS is often lower than global standards in...
OBJECTIVE
Although Pap smear (PS) is considered the best standard in detecting cervical cancer, adherence to timely and regular PS is often lower than global standards in developing countries. Thus, the present study aimed to identify barriers and facilitators of adherence to cervical cancer screening in Mashhad, Iran.
DESIGN
A qualitative content analysis was done from July to December 2022 using semistructured in-depth interviews.
SETTING
The study was conducted in health centres in Mashhad, Iran.
PARTICIPANTS
A sample of 36 married women aged 18-70 years was selected using a purposive sampling, with maximum diversity.
RESULTS
The mean age of participants was 42.8±7.6 years. Among all, 66.7% had the PS test at least once; only 8.3% regularly had the test. The qualitative content analysis led to the extraction of four major themes: (1) individual challenges, (2) environmental limitations, (3) individual motivators, and (4) supportive and efficient environments. The most significant barriers were psychological stress, unhealthy attitudes, insufficient information, cultural issues and insufficient healthcare services. Facilitators included an active and efficient healthcare system, advice and support of important others, and positive emotions and individual beliefs.
CONCLUSIONS
Participants' perceptions showed that the main factors influencing the PS testing were supportive environments, individual motivators, individual challenges and environmental limitations. To encourage women to take the PS and reduce barriers, it may be necessary to revise current health system policies, promote individual and public awareness, reduce psychological stress and correct negative beliefs and attitudes.
Topics: Female; Humans; Adult; Middle Aged; Early Detection of Cancer; Uterine Cervical Neoplasms; Papanicolaou Test; Health Policy; Perception
PubMed: 38191254
DOI: 10.1136/bmjopen-2023-072954 -
African Journal of Primary Health Care... Oct 2019Cervical cancer is the most common form of cancer in black women in South Africa and has almost a 60% mortality rate. However, adherence to cervical screening programmes...
BACKGROUND
Cervical cancer is the most common form of cancer in black women in South Africa and has almost a 60% mortality rate. However, adherence to cervical screening programmes of black women living in rural South Africa is not universal.
AIM
The aim of this study was to gain a better understanding of rural Zulu women's knowledge of and attitudes towards Pap smear tests, and their reasons for participation or non-compliance with cervical screening.
SETTING
This study was conducted at the gynaecology and antenatal clinics in a secondary referral hospital in rural KwaZulu-Natal.
METHODS
A hospital-based cross-sectional study was undertaken in the form of a semi-structured patient questionnaire survey with open and closed questions. The responses to the open-ended questions were manually analysed by the authors using a thematic approach. Outcome measures included whether the woman had a previous Pap smear, her understanding of the cervical screening programme and causes of cervical cancer.
RESULTS
This study included a total analysis of 234 responses. The mean age was 29 years (s.d. = 8.3 years). Overall, 32.5% of women had previously had a Pap smear. Among the responders, 33.3% were human immunodeficiency virus (HIV)-positive and 53.0% were HIV-negative. Only 19.2% of women understood that a Pap smear was related to screening for cervical cancer.
CONCLUSIONS
This study illustrated a poor understanding of cervical screening, which may result in the low level of uptake of Pap smear reported; this is particularly concerning in HIV-positive women, who are at higher risk of developing cervical cancer. Urgent and extensive public health campaigning is required within rural South Africa to improve cervical screening uptake and decrease cervical cancer mortality.
Topics: Adolescent; Adult; Aged; Black People; Contraception; Cross-Sectional Studies; Early Detection of Cancer; Female; HIV Infections; Health Knowledge, Attitudes, Practice; Humans; Middle Aged; Papanicolaou Test; Rural Population; Socioeconomic Factors; South Africa; Uterine Cervical Neoplasms; Young Adult
PubMed: 31588773
DOI: 10.4102/phcfm.v11i1.1994 -
Singapore Medical Journal Jan 2009Cervical cancer is one of the commonest cancers in women worldwide. Despite the existence of effective screening using Pap smear, the uptake of screening is poor. A...
INTRODUCTION
Cervical cancer is one of the commonest cancers in women worldwide. Despite the existence of effective screening using Pap smear, the uptake of screening is poor. A qualitative study was undertaken using face-to-face in-depth interviews to investigate knowledge, attitudes and beliefs on cervical cancer screening of Malaysian women.
METHODS
In-depth interviews were conducted with 20 Malaysian women aged 21-56 years and who have never had a Pap smear test, with the aim to explore their knowledge and awareness of cervical cancer and its screening.
RESULTS
A lack of knowledge on cervical cancer and the Pap smear test was found among the respondents. Many women did not have a clear understanding of the meaning of an abnormal cervical smear and the need for the early detection of cervical cancer. Many believe the purpose of the Pap smear test is to detect existing cervical cancer, leading to the belief that Pap smear screening is not required because the respondents had no symptoms. Despite considerable awareness of a link between cervical cancer and sexual activity, as well as the role of a sexually-transmitted infection, none of the respondents had heard of the human papillomavirus.
CONCLUSION
The findings highlight the importance of emphasising accurate information about cervical cancer and the purpose of Pap smear screening when designing interventions aimed at improving cervical cancer screening for Malaysian women.
Topics: Adult; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Interviews as Topic; Malaysia; Middle Aged; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 19224084
DOI: No ID Found -
Scientific Reports Jul 2021Cervical cancer affects more than 0.5 million women annually causing more than 0.3 million deaths. Detection of cancer in its early stages is of prime importance for...
Cervical cancer affects more than 0.5 million women annually causing more than 0.3 million deaths. Detection of cancer in its early stages is of prime importance for eradicating the disease from the patient's body. However, regular population-wise screening of cancer is limited by its expensive and labour intensive detection process, where clinicians need to classify individual cells from a stained slide consisting of more than 100,000 cervical cells, for malignancy detection. Thus, Computer-Aided Diagnosis (CAD) systems are used as a viable alternative for easy and fast detection of cancer. In this paper, we develop such a method where we form an ensemble-based classification model using three Convolutional Neural Network (CNN) architectures, namely Inception v3, Xception and DenseNet-169 pre-trained on ImageNet dataset for Pap stained single cell and whole-slide image classification. The proposed ensemble scheme uses a fuzzy rank-based fusion of classifiers by considering two non-linear functions on the decision scores generated by said base learners. Unlike the simple fusion schemes that exist in the literature, the proposed ensemble technique makes the final predictions on the test samples by taking into consideration the confidence in the predictions of the base classifiers. The proposed model has been evaluated on two publicly available benchmark datasets, namely, the SIPaKMeD Pap Smear dataset and the Mendeley Liquid Based Cytology (LBC) dataset, using a 5-fold cross-validation scheme. On the SIPaKMeD Pap Smear dataset, the proposed framework achieves a classification accuracy of 98.55% and sensitivity of 98.52% in its 2-class setting, and 95.43% accuracy and 98.52% sensitivity in its 5-class setting. On the Mendeley LBC dataset, the accuracy achieved is 99.23% and sensitivity of 99.23%. The results obtained outperform many of the state-of-the-art models, thereby justifying the effectiveness of the same. The relevant codes of this proposed model are publicly available on GitHub .
Topics: Databases, Factual; Diagnosis, Computer-Assisted; Female; Fuzzy Logic; Humans; Neural Networks, Computer; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 34267261
DOI: 10.1038/s41598-021-93783-8